About the role
Location: USF Faculty Office Building
%3Cp class=%22MsoNormal%22%3E%3Cspan style=%22font-family%5C:Arial, Helvetica, sans-serif;font-size%5C:16px;%22%3E%3Cspan style=%22line-height%5C:107%;%22%3EThe Claims Resolution Specialist I is responsible for the timely and accurate submission, follow‑up, and resolution of third‑party insurance claims to ensure correct reimbursement for services rendered. This position reviews assigned accounts, conducts status inquiries, processes appeals, and determines appropriate actions needed to resolve outstanding balances in accordance with departmental policies, payer guidelines, and regulatory requirements. The Specialist identifies trends impacting claims, assists with clean claim filing, and participates in special projects related to accounts receivable management. The role requires effective communication with payers, attention to detail, and adherence to State, Federal, and carrier regulations to support optimal financial performance for the organization.%26nbsp;%3C/span%3E%3C/span%3E%3C/p%3E%3Cp class=%22MsoNormal%22%3E%26nbsp;%3C/p%3E
%3Cp class=%22MsoNormal%22%3E%3Cspan style=%22font-family%5C:Arial, Helvetica, sans-serif;font-size%5C:16px;%22%3E%3Cspan style=%22line-height%5C:107%;%22%3ERequired%5C:%3C/span%3E%3C/span%3E%3C/p%3E%3Cp class=%22MsoNormal%22%3E%3Cspan style=%22font-family%5C:Arial, Helvetica, sans-serif;font-size%5C:16px;%22%3E%3Cspan style=%22line-height%5C:107%;%22%3EHigh School Diploma or GED%3C/span%3E%3C/span%3E%3C/p%3E%3Cp class=%22MsoNormal%22%3E%3Cspan style=%22font-family%5C:Arial, Helvetica, sans-serif;font-size%5C:16px;%22%3E%3Cspan style=%22line-height%5C:107%;%22%3E%3Cstrong%3EWork Experience and Additional Information%3C/strong%3E%26nbsp;%3C/span%3E%3C/span%3E%3C/p%3E%3Cp class=%22MsoNormal%22%3E%3Cspan style=%22font-family%5C:Arial, Helvetica, sans-serif;font-size%5C:16px;%22%3E%3Cspan style=%22line-height%5C:107%;%22%3E2 years’ experience in physician billing and collection experience%26nbsp;%26nbsp;%3C/span%3E%3C/span%3E%3C/p%3E%3Cp class=%22MsoNormal%22%3E%3Cspan style=%22font-family%5C:Arial, Helvetica, sans-serif;font-size%5C:16px;%22%3E%3Cspan style=%22line-height%5C:107%;%22%3E• CPT ICD10 experience%26nbsp;%3C/span%3E%3C/span%3E%3C/p%3E%3Cp class=%22MsoNormal%22%3E%3Cspan style=%22font-family%5C:Arial, Helvetica, sans-serif;font-size%5C:16px;%22%3E%3Cspan style=%22line-height%5C:107%;%22%3E• Experience with EPIC software%3C/span%3E%3C/span%3E%3C/p%3E%3Cp class=%22MsoNormal%22%3E%3Cspan style=%22font-family%5C:Arial, Helvetica, sans-serif;font-size%5C:16px;%22%3E%3Cspan style=%22line-height%5C:107%;%22%3E%3Cstrong%3ETechnical Knowledge, Skills, and Abilities%3C/strong%3E%3C/span%3E%3C/span%3E%3C/p%3E%3Ctable class=%22MsoNormalTable%22 style=%22border-collapse%5C:collapse;mso-padding-alt%5C:0in 0in 0in 0in;mso-yfti-tbllook%5C:1184;%22 border=%221%22 cellspacing=%220%22 cellpadding=%220%22 width=%220%22%3E%3Ctbody%3E%3Ctr style=%22height%5C:15.0pt;mso-yfti-firstrow%5C:yes;mso-yfti-irow%5C:0;%22%3E%3Ctd style=%22border-color%5C:windowtext;border-width%5C:1.0pt;height%5C:15.0pt;mso-border-alt%5C:solid windowtext .75pt;padding%5C:0in;width%5C:523.5pt;%22 valign=%22top%22 width=%22698%22%3E%3Cul style=%22margin-top%5C:0in;%22 type=%22disc%22%3E%3Cli class=%22MsoNormal%22 style=%22mso-list%5C:l2 level1 lfo1;tab-stops%5C:list .5in;%22%3E%3Cspan style=%22font-family%5C:Arial, Helvetica, sans-serif;font-size%5C:16px;%22%3E%3Cspan style=%22line-height%5C:107%;%22%3EUnderstanding of third‑party payer processes, claim workflows, denial reasons, and reimbursement methodologies.%26nbsp;%3C/span%3E%3C/span%3E%3C/li%3E%3C/ul%3E%3C/td%3E%3C/tr%3E%3Ctr style=%22height%5C:15.0pt;mso-yfti-irow%5C:1;%22%3E%3Ctd style=%22border-style%5C:none;height%5C:15.0pt;padding%5C:0in;width%5C:523.5pt;%22 valign=%22top%22 width=%22698%22%3E%3Cul style=%22margin-top%5C:0in;%22 type=%22disc%22%3E%3Cli class=%22MsoNormal%22 style=%22mso-list%5C:l0 level1 lfo2;tab-stops%5C:list .5in;%22%3E%3Cspan style=%22font-family%5C:Arial, Helvetica, sans-serif;font-size%5C:16px;%22%3E%3Cspan style=%22line-height%5C:107%;%22%3EKnowledge of State and Federal regulations, payer policies, appeal requirements, and compliance standards related to insurance claims.%26nbsp;%3C/span%3E%3C/span%3E%3C/li%3E%3C/ul%3E%3C/td%3E%3C/tr%3E%3Ctr style=%22height%5C:15.0pt;mso-yfti-irow%5C:2;%22%3E%3Ctd style=%22border-style%5C:none;height%5C:15.0pt;padding%5C:0in;width%5C:523.5pt;%22 valign=%22top%22 width=%22698%22%3E%3Cul style=%22margin-top%5C:0in;%22 type=%22disc%22%3E%3Cli class=%22MsoNormal%22 style=%22mso-list%5C:l3 level1 lfo3;tab-stops%5C:list .5in;%22%3E%3Cspan style=%22font-family%5C:Arial, Helvetica, sans-serif;font-size%5C:16px;%22%3E%3Cspan style=%22line-height%5C:107%;%22%3EAbility to analyze claim issues, identify trends, determine root causes, and recommend solutions that support clean claim submission and reduce denials.%26nbsp;%3C/span%3E%3C/span%3E%3C/li%3E%3C/ul%3E%3C/td%3E%3C/tr%3E%3Ctr style=%22height%5C:15.0pt;mso-yfti-irow%5C:3;%22%3E%3Ctd style=%22border-style%5C:none;height%5C:15.0pt;padding%5C:0in;width%5C:523.5pt;%22 valign=%22top%22 width=%22698%22%3E%3Cul style=%22margin-top%5C:0in;%22 type=%22disc%22%3E%3Cli class=%22MsoNormal%22 style=%22mso-list%5C:l5 level1 lfo4;tab-stops%5C:list .5in;%22%3E%3Cspan style=%22font-family%5C:Arial, Helvetica, sans-serif;font-size%5C:16px;%22%3E%3Cspan style=%22line-height%5C:107%;%22%3EStrong written and verbal communication skills for contacting payers, preparing appeals, and documenting claim activity accurately and professionally.%26nbsp;%3C/span%3E%3C/span%3E%3C/li%3E%3C/ul%3E%3C/td%3E%3C/tr%3E%3Ctr style=%22height%5C:15.0pt;mso-yfti-irow%5C:4;%22%3E%3Ctd style=%22border-style%5C:none;height%5C:15.0pt;padding%5C:0in;width%5C:523.5pt;%22 valign=%22top%22 width=%22698%22%3E%3Cul style=%22margin-top%5C:0in;%22 type=%22disc%22%3E%3Cli class=%22MsoNormal%22 style=%22mso-list%5C:l4 level1 lfo5;tab-stops%5C:list .5in;%22%3E%3Cspan style=%22font-family%5C:Arial, Helvetica, sans-serif;font-size%5C:16px;%22%3E%3Cspan style=%22line-height%5C:107%;%22%3ESkills to manage a high‑volume workload, prioritize tasks, meet deadlines, and follow department protocols to ensure timely claim resolution.%26nbsp;%3C/span%3E%3C/span%3E%3C/li%3E%3C/ul%3E%3C/td%3E%3C/tr%3E%3Ctr style=%22height%5C:15.0pt;mso-yfti-irow%5C:5;mso-yfti-lastrow%5C:yes;%22%3E%3Ctd style=%22border-style%5C:none;height%5C:15.0pt;padding%5C:0in;width%5C:523.5pt;%22 valign=%22top%22 width=%22698%22%3E%3Cul style=%22margin-top%5C:0in;%22 type=%22disc%22%3E%3Cli class=%22MsoNormal%22 style=%22mso-list%5C:l1 level1 lfo6;tab-stops%5C:list .5in;%22%3E%3Cspan style=%22font-family%5C:Arial, Helvetica, sans-serif;font-size%5C:16px;%22%3E%3Cspan style=%22line-height%5C:107%;%22%3EAbility to use billing systems, claim scrubbers, payer portals, and standard office software to review accounts, submit appeals, and track claim status.%26nbsp;%3C/span%3E%3C/span%3E%3C/li%3E%3C/ul%3E%3C/td%3E%3C/tr%3E%3C/tbody%3E%3C/table%3E%3Cp class=%22MsoNormal%22%3E%26nbsp;%3C/p%3E
USF Faculty Office Building (AMGHFOB)
13220 USF Laurel Dr
Tampa, 33612