Medical Claims Resolution I — Revenue Cycle Focus

Baptist-Health; Jacksonville (FL); On-site; USD 38,000 - 48,000; Full time

Job summary

Baptist Health in Jacksonville, FL, is hiring a full-time Claims Resolution Specialist I in the Hospital Billing Office for day shift. The role focuses on resolving medical claims with commercial and government payers, analyzing EOBs, and communicating with carriers to ensure proper payment.

Ideal candidates have 1–2 years in revenue cycle operations, knowledge of CPT/ICD-10/HCPCS, and strong detail-oriented problem-solving skills. Join a nonprofit health system serving Northeast Florida.

Qualifications

• High School Diploma is required.
• 1–2 years of Revenue Cycle Operations experience.
• Experience with CPT, ICD-10, HCPCS is preferred.

Responsibilities

• Review and resolve medical claims submitted to commercial insurance companies, third-party organizations, and government payers.
• Analyze explanations of benefits (EOBs) to verify proper payment.
• Communicate with insurance carriers and third-party representatives to complete claims processing and resolve claim issues.
• Follow-up daily on rejected billings, adjustments, corrected claims, overpayments, and denied claims.
• 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

Insurance Claims

Denials Resolution

EOB Review

Carrier Communication

Education

High School Diploma

Job description

Baptist Health in Jacksonville, FL, is hiring a full-time Claims Resolution Specialist I in the Hospital Billing Office for day shift. The role focuses on resolving medical claims with commercial and government payers, analyzing EOBs, and communicating with carriers to ensure proper payment.

Ideal candidates have 1–2 years in revenue cycle operations, knowledge of CPT/ICD-10/HCPCS, and strong detail-oriented problem-solving skills. Join a nonprofit health system serving Northeast Florida.