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Business Office Specialist I

Baptist Health Care

Pensacola, Florida

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JOB DETAILS
SKILLS
Accounts Receivable, Accounts Receivable Management, Adjudication, Billing, Business Services, Database Administration, Establish Priorities, Financial Trend Analysis, Healthcare, Healthcare Providers, Hospital, Insurance, Leadership, Medical Office, Medical Records, Nonprofit, Office Management, Orthopedics, Patient Care, Payment Posting, Primary Care, Problem Solving Skills, Process Improvement, Quality of Life, Reconciliation, Reimbursement, Risk Analysis, Sports Medicine, Time Management, Trend Analysis
LOCATION
Pensacola, Florida
POSTED
9 days ago
JOB DESCRIPTION

The Business Office Specialist is responsible for performing duties in multiple CBO departments including accounts receivable follow up, payment posting, and charge posting as well as completing critical special projects and presentations related to accounts receivable reporting.

RESPONSIBILITIES

  • Investigates open items on the accounts receivable as identified by Leadership, that have aged beyond 30 days from the date submitted to the appropriate insurance carrier to facilitate claims adjudication.
  • Contacts insurance carriers, patients and health care providers by telephone and correspondence to assist with claims adjudication.
  • Reconciles account balances by posting, correcting and reapplying patient and insurance payments for assigned financial class. Posts the corresponding contractual adjustments to patient accounts to reconcile account balances.
  • Investigates and resolves account denials by submitting appeals and following up on appeals as needed to support the denial team.
  • Maintains accounts receivable database, including updating patient account information.
  • Responsible for tracking and establishing trending of new issues which continuously occur with changes in industry.
  • Performs charge entry duties as necessary based on departmental needs.
  • Creates and presents comprehensive reports for management and providers including presentations of critical information related to financial data and process improvement.
  • Thoroughly research, track, and establish trending of issues related to accounts receivable.
  • Participates in meetings and communicates with insurance representatives addressing ongoing reimbursement issues on accounts receivable identified as high risk.
  • Investigates open items on the accounts receivable as identified by leadership, that have aged beyond 30 days from the date submitted to the appropriate insurance carrier to facilitate claims adjudication.
  • Contacts insurance carriers, patients and health care providers by telephone and correspondence to assist with claims adjudication.
  • Reconciles account balances by posting, correcting and reapplying patient and insurance payments for assigned financial class. Posts the corresponding contractual adjustments to patient accounts to reconcile account balances.
  • Investigates and resolves account denials by submitting appeals and following up on appeals as needed to support the denial team.
  • Maintains accounts receivable database, including updating patient account information as appropriate.
  • Participates in meetings and communicates with insurance representatives addressing ongoing reimbursement issues on accounts receivable identified as high risk.
  • Responsible for tracking and establishing trending of new issues which continuously occur with changes in industry.
  • Communicate questions or concerns to the business services manager/director or physician's office billing manager to ensure prompt resolution.
  • Prioritize work assigned and complete in a timely manner.
  • Performs charge entry duties as necessary based on departmental needs.
  • Creates and presents comprehensive reports for management and providers including presentations of critical information related to financial data and process improvement.
  • Thoroughly research, track, and establish trending of issues related to accounts receivable.


QUALIFICATIONS

Minimum Education
  • High School Diploma or Equivalent Required
  • High School Diploma or Equivalent Required

Minimum Work Experience
  • 1-3 years relevant revenue cycle experience Required
  • 1-3 years relevant revenue cycle experience Required


ABOUT US

Baptist Health Care is a not-for-profit health care system committed to improving the quality of life for people and communities in northwest Florida and south Alabama. The organization includesthree hospitals, four medical parks,Andrews Institute for Orthopaedic & Sports Medicine, and an extensive primary and specialty care provider network. With more than 4,000 team members, Baptist Health Care is one of the largest non-governmental employers in northwest Florida.

Baptist Health Care, Inc. is an Equal Opportunity Employer. BHC maintains and enforces a policy that prohibits discrimination against any workforce members or applicants for employment because of sex, race, age, color, disability, marital status, national origin, religion, genetic information, or other category protected by federal, state or local law. Certain positions may require a Level 2 Background check through AHCA. Additional information about this requirement can be found here: Florida Care Provi

About the Company

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Baptist Health Care