Global Claims Management Analyst, Remote, Physician Network Services, FT, 08:30A-5P

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 out 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 the execution of all Claims Management and Third Party Administrative (TPA) functions to support system-wide Domestic and International lines of businesses. Key responsibilities include the accurate audit, claim analysis, timely payer collections management and adjudication of medical claims. In addition to, maintaining, develop and administer the PNS Contract Management Process. Team Lead(s) back up for the Para-Claim Parathon solution management, to include analyzing claim data in order to identify anomalies, trends and discrepancies. Responsible for the physician claims appeal and reimbursement reconsideration process for all line of businesses. Supports Team Lead(s) and leadership in departmental process improvement initiatives. Supports department leaders and Team Lead during the payment and reconciliation process as needed. Estimated pay range for this position is $26.65 - $33.85 / hour depending on experience. Qualifications: Degrees: Associates. Additional Qualifications: Strong background in Medical Insurance Billing and collections, coding, claims regulations, revenue cycle, provider contract management, operational support and registration. Must have a solid understanding of hospital operations, contractual analysis, FDA health regulations, HIPPA regulations, DRG guidelines, as well as possess exceptional administrative skills. Thorough understanding of all required fields on a 1500 and/or UB for hospitals, diagnostic facilities and physician practices required. Excellent written and verbal communication skills. Superb customer service skills needed. Ability to work independently, demonstrate a high level of initiative, prioritize deadlines and decision making abilities. Results driven, with a desire to work in a fast-paced environment that values collaboration, integrity and customer focused. Experience preferred with JDA ACO, Web Tool Parathon, EPSi, Soarian Financials, Cerner Power Chart, Business Objectives Enterprise, MS Power BI, Pro Diver or other payer modeling is essential. Minimum Required Experience: 5 Years EOE, including disability/vets