Claims Processor
Shands Healthcare - Gainesville, FL

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Claims Processor-
Researches and reviews bills for completeness and to ensure payer specfic guidelines are meet for correct billing to third party payers. Makes collection calls, and checks various payer systems to pursues payment of Third Party claims. Make appropriate determination for contractual adjustments, verifies system balances, calculates and post adjustments. Ensures financial integrity of Shands HealthCare by processing and expediting billing and collection processes.

Position Minimum Requirements

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

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