Claims Resolution Manager, Hybrid, Metro Square

About Baptist Health Recognized as a top place to work in health care, Baptist Health cares for more patients in Northeast Florida than any other provider, ranking as “most preferred” for more than 30 years. We’re Jacksonville's only locally governed, faith-based, not-for-profit health system and provide a full spectrum of preventive and specialty care through 200+ locations and six hospitals.

Our centers of excellence include Baptist MD Anderson Cancer Center, Baptist Heart Hospital, Baptist Neurological Institute and Wolfson Children's Hospital. Baptist Health is looking to add a Claims Resolution Manager in our Hospital Billing Department at Baptist Metro Square. This is a Full Time and Hybrid opportunity.

Baptist Jacksonville is a Magnet™ designated hospital, the gold standard for excellence in patient care. We serve families throughout the area with high-quality, comprehensive care for every stage of life. As a Claims Resolution Manager , you will be responsible for: Leads a team dedicated to physician billing claims follow up who can determine why a claim is underpaid or denied taking the necessary steps to resolve the claim to payment.

The manager possesses critical thinking skills and the ability to implement processes that improve efficiencies, optimize team members strengths, and consider system abilities or limitations. There is a focus on quality claims resolution rather than claim touch or productivity and enhancing team members skillsets and intrinsic motivation to find a solution to claim payment.

The manager has experience in both Managed Care and government payers and is capable of distinguishing internal process gaps versus payer related issues. Duties include strategic planning for staffing needs and cross training, workload distribution, and team member development such as mentorship, effective delegation, and open communication.

The manager is driven to find solutions and confident in making decisions based on pertinent information and metrics. Experience Requirements: 3-5 Years

• Denials Management Experience (Required) 3-5 Years
• Experience Hospital Claims Follow-Up Experience (Required) 3-5 Years
• Leadership Experience (Required) 3-5 Years
• Payer Strategy Experience (Required) 1-2 Years
• Process Improvement Experience (Required) 5+ Years
• Relevant equivalent experience in lieu of education (Required) 3-5 Years
• Appeals Management Experience (Required) Education & Credential Requirements: Bachelor's Degree
• Required This Claims Resolution Manager will be located at Baptist Metro Square. If you are interested in this Full-Time opportunity, please apply now Primary Location: Metro Square