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SalaryBaptist Health South Florida is the largest healthcare organization in the region, with 12 hospitals, more than 24,000 employees, 4,000 physicians and 100 outpatient centers, urgent care facilities and physician practices spanning across Miami-Dade, Monroe, Broward and Palm Beach counties. Baptist Health has internationally renowned centers of excellence in cancer, cardiovascular care, orthopedics and sports medicine, and neurosciences. A not-for-profit organization supported by philanthropy and committed to its faith-based charitable mission of medical excellence,Baptist Health has been recognized by Fortune as one of the 100 Best Companies to Work For in America and by Ethisphere as one of the World’s Most Ethical Companies.
Everything we do at Baptist Health, we do to the best of our ability. That includes supporting our team with extensive training programs, millions of dollars in tuition assistance, comprehensive benefits and more. Working within our award-winning culture means getting the respect and support you need to do your best work ever. Find out why we’re all in for helping you be your best.
Description:
Supervise, monitor and audit the day to day activities of the Claims Management unit related to underpayments, overpayments and credits. Responsible for the timely review and processing of underpayments to maximize cash collection. Responsible for the timely review and processing of the credits and refund requests received by the insurance companies, patients and other internal or external sources. Responsible to identify internal and external issues and report them to Management. Assist in gathering the necessary data and validate the accuracy of such for payers litigation and participate in legal actions as necessary.
Qualifications:
Degrees: High School,Cert,GED,Trn,Exper Additional Qualifications: Knowledge of reimbursement methodologies, DRGs, APCs, EAPGs, Medical necessity, Correct coding initiatives, Revenue codes, CPTs, HCPCS, Diagnosis codes. Knowledge with UB-02 and HCFA 1500, Internet savvy, Interpret and understand insurance companies contracts. Knowledge of Microsoft software systems: word and excel is a must. Extensive analytical and critical thinking skills and details oriented. Excellent mathematical writing and interpersonal skills required. Must be able to communicate effectively with insurance carriers and internal department. Excellent time-management skills, ability to multi-task and work under pressure in order to meet goals and deadlines. Minimum Required Experience:
EOE
