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Payment Compliance Specialist

Baptist Health Care
United States, Florida, Pensacola
Jan 19, 2025
Job Description The Payment Compliance Specialist is responsible for the timely identification, research and resolution of variances between expected payments and actual payments from managed care contracted insurance companies. Responsibilities Identify variances by working reports and analyzing data to determine if a payment is underpaid. Able to work in multiple PC based applications for thorough account management. Research trends and detect root causes of payment variances. Completes a comprehensive review and study of applicable contracts, insurance payment policies and procedures. Recover underpayments and hold payers accountable to reimbursement commitments. Ensuring correct payment from payers with professional and effective communication. Qualifications Minimum Education High School Diploma or Equivalent Required Minimum Work Experience 1-3 years relevant health care revenue cycle experience. Preferred 1-3 years experience in a hospital, medical billing, coding, auditing or insurance collections. Preferred About Us Baptist Health Care is a not-for-profit health care system committed to improving the quality of life for people and communities in northwest Florida and south Alabama. The organization includes three hospitals, four medical parks, Andrews Institute for Orthopaedic & Sports Medicine, and an extensive primary and specialty care provider network. With more than 4,000 team members, Baptist Health Care is one of the largest non-governmental employers in northwest Florida. Baptist Health Care, Inc. is an Equal Opportunity Employer. BHC maintains and enforces a policy that prohibits discrimination against any workforce members or applicants for employment because of sex, race, age, color, disability, marital status, national origin, religion, genetic information, or other category protected by federal, state or local law.