Baptist Health South Florida is the region’s largest not-for-profit healthcare organization with 12 hospitals, more than 27,000 employees, 4,000 physicians, and 200 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. Baptist Health is supported by philanthropy and committed to its faith-based charitable mission of medical excellence.
Our mission, vision, and values make us who we are at Baptist Health and are at the center of everything we do. At Baptist Health, we positively impact the human experience for patients, employees, and physicians. Our success comes from a culture of quality and dedication that is instilled into every member of the Baptist Health family.
This year, and for 24 years, we’ve been named one of Fortune’s 100 Best Companies to Work For, based on employee feedback. We’ve also been recognized as one of America’s Most Innovative Companies and People Magazine included us in 50 Companies That Care. Based on the U.S. News & World Report 2023-2024 Best Hospital Rankings, Baptist Health is the most awarded healthcare system in South Florida, with its hospitals and institutes earning 45 high-performing honors.
But really, the reason we’re excited to come to work is the people.
Working together, we form personal connections with our colleagues that are stronger than most of us have experienced at other jobs. We develop caring relationships with our patients and their families that go beyond just delivering healthcare. After all, we know what it’s like to be in their shoes. Many of us have been patients here and have had family members as patients here. We’re committed to delivering quality care in the most compassionate way possible because we feel a personal stake in the outcomes. When it comes to caring for people, we’re all in.
Description
Timely follow up for all assigned accounts utilizing A/R reports and account maintenance activities to ensure timely collection of all outstanding balances. Utilizes all available resources for proper claims resolution. Understands payer guidelines for effective denial management utilizing understanding of ICD-10, CPT-4 and associated modifiers. Understands the different levels in the appeals process to optimize recovery efforts. Reviews medical record documentation and understands the documentation needed for the overturning of denials generated by insurance companies. Recognizes resources for drug information and medical necessity terms and definitions. Understands the components of the FDA Label. Uses compendia resources to assist in medical necessity appeals. Estimated pay range for this position is $16.52 - $19.99 / hour depending on experience.
Qualifications
Degrees:
- High School,Cert,GED,Trn,Exper.
Additional Qualifications
- Experience in billing, collections and appeals.
- Demonstrate proficiency with MS Word and Excel.
- Excellent communications skills (both written and verbal) detail oriented and excellent problem solver.
- Knowledge and understanding of medical terminology, explanation of benefits and insurance verification applications.
- Knowledge and understanding of ICD-10, CPT-4 and modifiers.
Minimum Required Experience
EOE
