Government Billing Spec 2, Remote, Business Office, FT, 08A-4:30P

Baptist Health; Miami (FL); Remote; USD 100,000 - 125,000; Full time

Job summary

An established industry player in healthcare is seeking a dedicated claims specialist to manage Governmental Program claims. In this pivotal role, you will ensure the timely and accurate submission of claims, adhering to all regulatory guidelines while training new staff. Your expertise in Medicare and Medicaid billing, along with strong analytical and communication skills, will be crucial in resolving claims issues and meeting daily transmission goals. Join a team committed to excellence in patient care and operational efficiency, where your contributions will directly impact the revenue cycle and support the healthcare community.

Qualifications

• 4-7 years of experience in billing of claims required.
• CPC, CPC-H, CCS, RMC certifications a plus.

Responsibilities

• Optimize timely transmittal of accurate claims.
• Communicate effectively with BHSF departments to resolve delays.

Skills

Analytical Skills

Detail-oriented

Problem-solving

Communication Skills

Time Management

Interpersonal Skills

Education

High School diploma or equivalent

BA preferred

Tools

Microsoft Suite

Medical Terminology

Job description

Description:

Responsible for working/editing the daily download of assigned Governmental Program claims while adhering to all regulatory, contractual, compliance, and BHSF mandates/guidelines. Optimizes the 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 backup to bill all carriers.

Estimated pay range for this position is $19.73 - $23.87 / hour depending on experience.

Qualifications:

• High School diploma, certificate, GED, training, or experience.

• 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 fully meets or exceeds merit rating of 3.
• Ability to train personnel is a must.
• Knowledge of all required fields on a 1500 and UB forms for hospitals and diagnostic facilities.
• Extensive knowledge of government-related regulations (federal, state, and local) for Medicare, Medicaid, Champus/Tricare.
• Understanding of Medical Necessity and Correct Coding Initiative.
• Experience in other related Business Office functions, including Government Funded programs.
• Experience with adjudication of claims is desirable.
• Working knowledge of medical terminology, revenue codes, DRG guidelines, ICD-9/10, CPT-4, modifiers & HCPCS codes, HIPAA, online verifications, internet proficiency, and Microsoft Suite.
• Excellent analytical, critical thinking, detail-oriented, problem-solving, math, writing, and interpersonal skills.
• Ability to report issues to management and IT support.
• Effective communication with other departments to resolve pending or missing information on claims to meet daily transmission goals.
• Excellent time management skills.
• Ability to multi-task and work under pressure.

Minimum required experience: 4 years.

EOE, including disability/vets