Baptist Health
Claims Variance Assoc 3, Remote, Business Office, FT, 08A-4:30P
Baptist Health, Miami, Florida, United States, 33101
Data Analysis Lead Expert
Responsible for serving as a lead expert in data analysis, reporting and formulating recommendations. Provides guidance and support to all variance associates. Responsible for assisting management with the gathering, verification and analysis of Managed Care underpayment variance reports for all BHSF entities. Responsible for the organization and preparation of all Managed Care Insurance Carriers projects and Insurance Law Suits. Estimated pay range for this position is $26.50 - $32.07 / hour depending on experience. Degrees: High School,Cert,GED,Trn,Exper. Additional Qualifications: Prior experience in working with Hospital Collection Reimbursement. Ability to train personnel a must. Knowledgeable on all required fields on a 1500 and UB for hospitals and diagnostic facilities a must. Extensive knowledge in the adjudication of claims; working knowledge and understanding of: Insurance Explanation of Benefits; different hospital payment methodologies; medical terminology; Revenue Codes; DRG guidelines; ICD9, CPT4, Modifiers & HCPC codes; Online claim status; Internet savvy; Knowledge of Microsoft systems, Excel (must have a passing score on the Basic excel test). Extensive analytical; critical thinking; detail oriented; problem solver; good math, writing, and interpersonal skills required. Must be able to report issues to management, communicate with other internal depts and other business partners in order to resolve problem accounts. Excellent Time Management skills. Ability to multi-task and work under pressure in order to meet stringent deadlines. Minimum Required Experience: 10 Years EOE, including disability/vets
Responsible for serving as a lead expert in data analysis, reporting and formulating recommendations. Provides guidance and support to all variance associates. Responsible for assisting management with the gathering, verification and analysis of Managed Care underpayment variance reports for all BHSF entities. Responsible for the organization and preparation of all Managed Care Insurance Carriers projects and Insurance Law Suits. Estimated pay range for this position is $26.50 - $32.07 / hour depending on experience. Degrees: High School,Cert,GED,Trn,Exper. Additional Qualifications: Prior experience in working with Hospital Collection Reimbursement. Ability to train personnel a must. Knowledgeable on all required fields on a 1500 and UB for hospitals and diagnostic facilities a must. Extensive knowledge in the adjudication of claims; working knowledge and understanding of: Insurance Explanation of Benefits; different hospital payment methodologies; medical terminology; Revenue Codes; DRG guidelines; ICD9, CPT4, Modifiers & HCPC codes; Online claim status; Internet savvy; Knowledge of Microsoft systems, Excel (must have a passing score on the Basic excel test). Extensive analytical; critical thinking; detail oriented; problem solver; good math, writing, and interpersonal skills required. Must be able to report issues to management, communicate with other internal depts and other business partners in order to resolve problem accounts. Excellent Time Management skills. Ability to multi-task and work under pressure in order to meet stringent deadlines. Minimum Required Experience: 10 Years EOE, including disability/vets