Claims Resolution Specialist 1 jobs in United States
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Tampa General Hospital · 6 days ago

Claims Resolution Specialist 1

positionTampa, FL
timeFull-time
remoteHybrid
seniorityEntry Level
money$35K/yr - $35K/yr
date2+ years exp

Tampa General Hospital is an academic medical group seeking a Claims Resolution Specialist 1 to manage third party claims efficiently. The role involves reviewing accounts, submitting claims, performing status inquiries, and handling appeals to ensure proper reimbursement while adhering to departmental guidelines.

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Growth Opportunities

Responsibilities

Responsible for prompt and accurate submission and follow-up of all third party claims
Reviews assigned accounts perform status inquiry and appeals to 3rd party payers to ensure reimbursement
Reviews assigned accounts, determines appropriate action to resolve outstanding balances
Works within the established guidelines of the department’s procedures, policies and goals
Conduct studies/special projects to resolve outstanding accounts receivables
Contact payers regarding outstanding claim status and determine appropriate action for swift resolution of outstanding claims
Process appeals and claim resubmissions per payer policy and identify any trends that may allow for a front end edit to be put in place to assist with clean claim filing
As a Senior Claims Specialist, you will be expected to provide assistance to coworkers on the floor ensure all are supported in their daily functions
Responsible for 2nd/3rd level appeals for any and all payers, making certain documentation being sent includes all necessary items to support our claim
Stay current on carrier guidelines, as well as State and Federal regulations

Qualification

CPT ICD9 experiencePhysician billing experienceClaims processingIDX SoftwareAppeals processingRegulatory knowledgeTeam support

Required

High School Diploma

Preferred

2 years experience in physician billing and collection experience
CPT ICD9 experience
IDX Software

Company

Tampa General Hospital

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Tampa General Hospital is a medical center.
dateFounded in 1927
location
Tampa, Florida, USA
people-size10001+ employees
web-link
https://www.tgh.org

Funding

Current Stage
Late Stage
Total Funding
unknown
2024-09-26Grant

Leadership Team

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Jennifer Crabtree
President, Tampa Medical & Research District | Senior Vice President, Tampa General Hospital
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Kate Ulrich
SVP Perioperative Services
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Recent News

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