Contractual Medical Excellence Jobs (NOW HIRING)

Baptist Health is the region's largest not-for-profit healthcare organization, with 12 hospitals, over 29,000 employees, 4,500 physicians and 200 outpatient centers, urgent care facilities and physician practices across Miami-Dade, Monroe, Broward and Palm Beach counties. With internationally renowned centers of excellence in cancer, cardiovascular care, orthopedics and sports medicine, and neurosciences, Baptist Health is supported by philanthropy and driven by its faith-based mission of medical excellence. For 26 years, we've been named one of Fortune's 100 Best Companies to Work For, and in the 2025-2026 U.S. News & World Report Best Hospital Rankings, Baptist Health was the most awarded healthcare system in South Florida, earning 63 high-performing honors.
What truly sets us apart is our people. At Baptist Health, we create personal connections with our colleagues that go beyond the workplace, and we form meaningful relationships with patients and their families that extend beyond delivering care. Many of us have walked in our patients' shoes ourselves and that shared experience fuels our commitment to compassion and quality. Our culture is rooted in purpose, and every team member plays a part in making a positive impact - because when it comes to caring for people, we're all in.
At Baptist Health, we're committed to supporting our employees at every stage of their journey, both personally and professionally. Our approach is rooted in a "grow our own" philosophy, designed to help our team members build meaningful, long-term careers with us, supported by benefits that make a real difference, including:

• Career growth and development opportunities, with clear pathways and ongoing support
• Comprehensive health and wellness resources that go beyond traditional benefits
• A wellness program that can help employees eliminate their medical plan deductible, reducing out-of-pocket healthcare costs
• Tuition reimbursement to support continued learning and advancement
• And so much more

Together, these benefits and others reflect our commitment to caring for our people, so they can build fulfilling careers with us while making a meaningful impact every day.
Description
Responsible for working/editing daily download of assigned Managed Care/HOM claims, optimizing the timely transmittal of accurate and clean claims daily Billing Specialist I is responsible for identifying and obtaining invalid/missing claim data by communicating with other depts. to secure and/or correct the data which prevents claim transmission Protects payer filing deadlines by utilizing all available resources to resolve held claims assures all known regulatory, contractual, compliance, and BHSF guidelines are adhered to. Must be willing to take on additional queues as back up to billing all carriers. Utilizes available system resources to resolve claim issues when appropriate reports any billing system issues to Billing management assists other Billing Specialists with claim resolution or other projects as assigned. Estimated pay range for this position is $16.04 - $19.41 / hour depending on experience.
Qualifications:
Responsible for working/editing daily download of assigned Managed Care/HOM claims, optimizing the timely transmittal of accurate and clean claims daily Billing Specialist I is responsible for identifying and obtaining invalid/missing claim data by communicating with other depts. to secure and/or correct the data which prevents claim transmission Protects payer filing deadlines by utilizing all available resources to resolve held claims assures all known regulatory, contractual, compliance, and BHSF guidelines are adhered to. Must be willing to take on additional queues as back up to billing all carriers. Utilizes available system resources to resolve claim issues when appropriate reports any billing system issues to Billing management assists other Billing Specialists with claim resolution or other projects as assigned. Estimated pay range for this position is $16.04 - $19.41 / hour depending on experience.Degrees:

• High School,Cert,GED,Trn,Exper.

Additional Qualifications:

• AA preferred or equivalent.
• Managed Care/HMO contract billing experience required.
• 3-5 years prior experience in Billing of claims.
• Understanding of all required fields on a 1500 and/or UB for hospitals and diagnostic facilities is required.
• Background in coding or coding certification (CPC, CPC-H, CCS, or RMC) a plus.
• Exp in other related Business Office Functions including Federal Programs, such as: Collections, refunds, review and adjudication of claims a plus.
• Knowledge and understanding of: Medical terminology, Correct Coding Initiative, Revenue Codes, DRG Guidelines, ICD-9/10, CPT-4, Modifiers & HCPCS codes, HIPAA regulations, statutory regulations, On-line verifications (DDE) ; Internet savvy ; knowledge of Microsoft Suite a must.
• Extensive analytical ; critical thinking ; detail oriented ; problem solver ; good mathematical, writing, and interpersonal skills required.
• Must be able to communicate effectively with other depts.
• in order to resolve pending/missing information on claims to expedite the timely transmission to payers.
• Excellent Time-Management skills.
• Ability to multi-task and work under pressure in order to meet stringent deadlines.

Minimum Required Experience: 3 YearsDegrees:

• High School,Cert,GED,Trn,Exper.

Additional Qualifications:

• AA preferred or equivalent.
• Managed Care/HMO contract billing experience required.
• 3-5 years prior experience in Billing of claims.
• Understanding of all required fields on a 1500 and/or UB for hospitals and diagnostic facilities is required.
• Background in coding or coding certification (CPC, CPC-H, CCS, or RMC) a plus.
• Exp in other related Business Office Functions including Federal Programs, such as: Collections, refunds, review and adjudication of claims a plus.
• Knowledge and understanding of: Medical terminology, Correct Coding Initiative, Revenue Codes, DRG Guidelines, ICD-9/10, CPT-4, Modifiers & HCPCS codes, HIPAA regulations, statutory regulations, On-line verifications (DDE) ; Internet savvy ; knowledge of Microsoft Suite a must.
• Extensive analytical ; critical thinking ; detail oriented ; problem solver ; good mathematical, writing, and interpersonal skills required.
• Must be able to communicate effectively with other depts.
• in order to resolve pending/missing information on claims to expedite the timely transmission to payers.
• Excellent Time-Management skills.
• Ability to multi-task and work under pressure in order to meet stringent deadlines.

Minimum Required Experience: 3 Years