ZipRecruiter

Log In

1

Live In Claims Resolution Specialist Jobs in Florida

next page

Showing results 1-20

All JobsLive In Claims Resolution Specialist JobsLive In Claims Resolution Specialist Jobs in Florida

Live In Claims Resolution Specialist information

What is the difference between Live In Claims Resolution Specialist vs Claims Adjuster?

AspectLive In Claims Resolution SpecialistClaims Adjuster
CredentialsRelevant insurance certifications, claims trainingInsurance licenses, certifications often required
Work EnvironmentOn-site, often in client homes or officesOffice-based or remote, fieldwork possible
Employer & IndustryInsurance companies, third-party administratorsInsurance carriers, independent agencies
Search & Comparison IntentSimilar roles handling claims, resolution processClaims processing, settlement, and adjustment

Both roles involve handling insurance claims, but Live In Claims Resolution Specialists typically work directly with clients on-site to resolve claims, while Claims Adjusters often work in offices or remotely to evaluate and settle claims. The roles share similar certifications and industry usage, but differ mainly in work environment and daily responsibilities.

What is a live in claims resolution specialist?

A live-in claims resolution specialist is a professional who works on-site to review, investigate, and resolve insurance claims promptly. They often handle complex cases, communicate directly with claimants, and may use specialized software to assess coverage and settlement options, typically working full-time in an office or client environment.

What are the most commonly searched types of Claims Resolution Specialist jobs in Florida?

The most popular types of Claims Resolution Specialist jobs in Florida are:

What cities in Florida are hiring for Live In Claims Resolution Specialist jobs?

Cities in Florida with the most Live In Claims Resolution Specialist job openings:

Live In Claims Resolution Specialist jobs near you

Claims Resolution Specialist III, Hospital Billing, Baptist Metro Square

Baptist Medical Center Jacksonville

Jacksonville, FL • On-site

$52 - $68/hr

Other

Posted 3 days ago

New

Baptist Health (Jacksonville) rating

6.1

Company rating: 6.1 out of 10

Based on 19 frontline employees who took The Breakroom Quiz

Job description

Baptist Health is looking to add a Claims Resolution Specialist III to our Hospital Billing team at Baptist Metro Square. This is a Full-Time Days opportunity.

The Claims Resolution Specialist III should have expertise in the following areas within the revenue Cycle: Registration, Eligibility, Charge Capture, Clearinghouse, Payment Posting, Claim Denial, and Credit Management.

As a Claims Resolution Specialist III, you will be responsible for:
  • Appropriately resolving each medical claim sent to commercial insurance companies, third party organizations and/or government payers.
  • Analyzing explanation of benefits to insure proper payment to Baptist Health from paying entities.
  • Communicating with third-party representatives as necessary to complete claims processing and /or resolve problem claims.
  • Follow-up daily on post processing activity including but not limited to, rejected billings, adjustments, corrected claims, overpayments, and denied claims.
  • Working all assigned accounts on worklist in order depending on balance and age.
  • Identifing and communicating trends in denials to leadership.
  • Communicating with various departments to resolve any outstanding issues with claim to resolve denials.
  • Possessing up to date knowledge related to CPT codes, ICD/10 codes.

This Claims Resolution Specialist III will be located at Baptist Metro Square.

High School

  • Accounts Receivable Experience
  • Revenue Cylce Operations Experience
  • Reimbursement Experience
  • Medical Insurance Experience
  • Knowledge of CPT, ICD10, HCPCS and Modifiers
  • Experience working in an Acute Care setting

Chosen as the area's “Most Preferred” healthcare provider every year since 1990 according to theannual National Research Corporation study of Jacksonville area residents, Baptist Health rankshighest in the categories of Best Doctors, Best Nurses, Best Quality and Best Reputation.

#J-18808-Ljbffr

What Baptist Health (Jacksonville) employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

Apply