Entry-Level Claims Resolution Specialist

Baptist Health; Jacksonville (FL); On-site; USD 42,000 - 64,000; Full time

Job summary

Baptist Health in Jacksonville, FL seeks a Claims Resolution Specialist I – Hospital Billing Office to join a full-time day-shift team. You will review and resolve medical claims, analyze EOBs, and collaborate with insurers and internal departments to ensure accurate payments.

The ideal candidate has 1–2 years in revenue cycle operations, plus experience in accounts receivable, billing, and medical insurance. A strong attention to detail and problem-solving skills are essential.

Qualifications

• 1–2 years of Revenue Cycle Operations experience (Required)
• Less than 1 year of Accounts Receivable experience (Required)
• Less than 1 year of Billing experience (Required)
• Less than 1 year of Medical Insurance experience (Required)
• Less than 1 year of Reimbursement experience (Required)
• Less than 1 year of knowledge or experience with CPT, ICD‑10, HCPCS, and modifiers (Required)

Responsibilities

• Review and resolve medical claims submitted to commercial insurance companies, third-party organizations, and government payers.
• Analyze explanations of benefits (EOBs) to verify appropriate payment to Baptist Health.
• Communicate with insurance carriers and third-party representatives to complete claims processing and resolve claim issues.
• Perform daily follow‑up on rejected billings, adjustments, corrected claims, overpayments, and denied claims.
• Work assigned accounts according to balance and account age to support timely resolution and reimbursement.
• Identify and communicate denial trends to leadership and collaborate with internal departments to resolve outstanding claim issues.
• Maintain knowledge of CPT, ICD‑10, HCPCS, and modifiers while developing competency across assigned Hospital Billing (HB) or Physician Billing (PB) revenue cycle functions.

Skills

Revenue Cycle

Accounts Receivable

Billing

Medical Insurance

Reimbursement

CPT/ICD-10/HCPCS

Education

High School Diploma

Job description

Baptist Health in Jacksonville, FL seeks a Claims Resolution Specialist I – Hospital Billing Office to join a full-time day-shift team. You will review and resolve medical claims, analyze EOBs, and collaborate with insurers and internal departments to ensure accurate payments.

The ideal candidate has 1–2 years in revenue cycle operations, plus experience in accounts receivable, billing, and medical insurance. A strong attention to detail and problem-solving skills are essential.