Job Details

Baptist Health is the region's largest not-for-profit healthcare organization, with 12 hospitals, over 29,000 employees, 4,500 physicians and 200 outpatient centers, urgent care facilities and physician practices across Miami-Dade, Monroe, Broward and Palm Beach counties. With internationally renowned centers of excellence in cancer, cardiovascular care, orthopedics and sports medicine, and neurosciences, Baptist Health is supported by philanthropy and driven by its faith-based mission of medical excellence. For 25 years, we've been named one of Fortune's 100 Best Companies to Work For, and in the 2024-2025 U.S. News & World Report Best Hospital Rankings, Baptist Health was the most awarded healthcare system in South Florida, earning 45 high-performing honors.

What truly sets us apart is our people. At Baptist Health, we create personal connections with our colleagues that go beyond the workplace, and we form meaningful relationships with patients and their families that extend beyond delivering care. Many of us have walked in our patients' shoes ourselves and that shared experience fuels out commitment to compassion and quality. Our culture is rooted in purpose, and every team member plays a part in making a positive impact - because when it comes to caring for people, we're all in.

Description

Responsible for working/editing daily download of assigned Governmental Program claims while adhering to all regulatory, contractual, compliance and BHSF mandates/guidelines. Optimizes timely transmittal of accurate and clean claims to achieve daily set thresholds. Protects payer filing deadlines by utilizing all available resources to resolve held claims. Communicates effectively with all BHSF Departments responsible for Revenue Cycle delays and works with Billing Management to achieve resolution. Responsible for training new employees and assisting management with auditing queues during the probation period. Must be willing to take on additional queues as back up to bill all carriers. Estimated pay range for this position is $20.02 - $24.22 / hour depending on experience.

Qualifications:
Responsible for working/editing daily download of assigned Governmental Program claims while adhering to all regulatory, contractual, compliance and BHSF mandates/guidelines. Optimizes timely transmittal of accurate and clean claims to achieve daily set thresholds. Protects payer filing deadlines by utilizing all available resources to resolve held claims. Communicates effectively with all BHSF Departments responsible for Revenue Cycle delays and works with Billing Management to achieve resolution. Responsible for training new employees and assisting management with auditing queues during the probation period. Must be willing to take on additional queues as back up to bill all carriers. Estimated pay range for this position is $20.02 - $24.22 / hour depending on experience.Degrees:

• High School,Cert,GED,Trn,Exper.

Additional Qualifications:

• BA preferred or equivalent Medicare or Medicaid Billing experience required.
• 4-7 years prior experience in Billing of claims.
• CPC, CPC-H, CCS, RMC certifications a plus.
• Current BHSF employees must have a high fully meets or exceeds merit rating 3.
• 5 - 4.
• 0.
• Ability to train personnel a must.
• Know all required fields on a 1500 and UB for hospitals and diagnostic facilities a must.
• Extensive knowledge with Govt related regulations National, State, and Local, for Medicare, Medicaid,Champus/Tricare.
• Medical Necessity and Correct Coding Initiative a must.
• Exp in other related Business Office functions incl Government Funded programs.
• Adjudication of claims is desirable.
• Working knowledge and understanding of: medical terminology ; Revenue Codes ; DRG guidelines ; ICD9/10, CPT4, Modifiers & HCPC codes ; HIPAA ; Online verifications DDE ; Internet savvy ; Knowledge of Microsoft Suite a must.
• Extensive analytical ; critical thinking ; detail oriented ; problem solver ; good math, writing, and interpersonal skills required.
• Must be able to report issues to management, IT support.
• Communicate with other depts in order to resolve pending or missing inf on the claim to meet daily transmissions.
• Excellent Time Management skills.
• Ability to multi-task and work under press.

Minimum Required Experience: 4 YearsDegrees:

• High School,Cert,GED,Trn,Exper.

Additional Qualifications:

• BA preferred or equivalent Medicare or Medicaid Billing experience required.
• 4-7 years prior experience in Billing of claims.
• CPC, CPC-H, CCS, RMC certifications a plus.
• Current BHSF employees must have a high fully meets or exceeds merit rating 3.
• 5 - 4.
• 0.
• Ability to train personnel a must.
• Know all required fields on a 1500 and UB for hospitals and diagnostic facilities a must.
• Extensive knowledge with Govt related regulations National, State, and Local, for Medicare, Medicaid,Champus/Tricare.
• Medical Necessity and Correct Coding Initiative a must.
• Exp in other related Business Office functions incl Government Funded programs.
• Adjudication of claims is desirable.
• Working knowledge and understanding of: medical terminology ; Revenue Codes ; DRG guidelines ; ICD9/10, CPT4, Modifiers & HCPC codes ; HIPAA ; Online verifications DDE ; Internet savvy ; Knowledge of Microsoft Suite a must.
• Extensive analytical ; critical thinking ; detail oriented ; problem solver ; good math, writing, and interpersonal skills required.
• Must be able to report issues to management, IT support.
• Communicate with other depts in order to resolve pending or missing inf on the claim to meet daily transmissions.
• Excellent Time Management skills.
• Ability to multi-task and work under press.

Minimum Required Experience: 4 Years