Claims Processor, Government Team

This is a remote position within Florida.

Researches and reviews claims for accuracy and to ensure payer-specific guidelines are met for correct billing to third-party payers. Makes payer calls and/or utilizes payer portals/resources systems to pursue payment of third-party claims. Makes appropriate determination for contractual adjustments, verifies system balances and calculates and posts adjustments. Ensures financial integrity of Shands HealthCare by processing and expediting billing and collection processes.

Minimum Education and Experience Requirements:

• Must be able to deal effectively with the public and be able to use good judgment in the pursuit of resolving accounts.
• College education may be substituted for experience.
• Experience with computerized insurance billing system and Microsoft programs preferred.
• Prefer some college-level business, finance or accounting courses.
• Medical terminology preferred.
• Must have above average math skills and be proficient on a calculator.
• Must be able to demonstrate the ability to communicate well with others and work independently under pressure and consistently achieve desired results.
• Experience in Blue Cross, Medicare, Medicaid and/or other third-party payer billing or collections preferred.
• Minimum high school graduate or equivalent.
• Requires six months of billing/collection experience in a hospital and/or physician's office or a minimum of one year of experience in a business setting dealing with finance, accounting or insurance portal systems.