File Resolution Specialist (St. Paul Minnesota)

This is where you save and sustain lives

At Baxter, we are deeply connected by our mission. No matter your role at Baxter, your work makes a positive impact on people around the world. You'll feel a sense of purpose throughout the organization, as we know our work improves outcomes for millions of patients.

Baxter's products and therapies are found in almost every hospital worldwide, in clinics and in the home. For over 85 years, we have pioneered significant medical innovations that transform healthcare.

Together, we create a place where we are happy, successful and inspire each other. This is where you can do your best work.

Join us at the intersection of saving and sustaining lives- where your purpose accelerates our mission.

Your Role at Baxter

This is where your insights influence change.

Your belief in hard work, critical thinking, and analytical approach is essential in understanding the big picture as well as collaborating on solutions. Though your talent is needed across a wide array of work environments, your preference is working at a large, stable company. One that appreciates your skills and actively invests in your career.

As a File Resolution Specialist at Baxter, you have the opportunity to work with our internal team as well as collaboratively with the teams we support. As a valued member of our finance organization, your insights and technical expertise will support our operations and contribute to our goals. You are able to adapt quickly, and thrive in nearly any situation due to your friendly, open approach to work. Your colleagues and business unit leaders will support you as you grow your professional skills at Baxter.

Your Team

Baxter is a large, global company that provides rich opportunities to develop professionally and learn from one another. Our mission to save and sustain lives is backed by a strong business model and over 90 years of success and growth.

As our company's mission comes to life, it brings vast amounts of data with it. The finance organization has the responsibility and privilege of translating this data into meaningful, practical insights to help teams learn and adapt along the way.

The File Resolution Specialist is responsible for providing direct support to the Revenue Cycle Management Department, which includes Reimbursement Services, Medicare, Billing and Collections Teams. This position requires use of data analysis tools and reporting, along with comprehensive understanding of the revenue cycle, to analyze and resolve patient files that did not follow the standard reimbursement process. Additionally, this position will work with the management team to identify process and procedure gaps, to ensure maximum reimbursement potential.

What you'll be doing

• Develop a plan and/or strategy to get patient accounts back into the reimbursement process flow, either through acquiring prior authorization, performing change of insurance, and/or acquiring payment on claims.
• Complete sophisticated research on patient accounts from intake, through billing and collections, to identify the gaps preventing reimbursement, and provide a summary for resolution.
• Apply various investigational tools such as Lexus Nexus, or Google to locate patient contact info, including use of classified and confidential database.
• Identify trends and opportunities for improvement in various processes, to increase profitability and cash flow, along with recommended solutions to the RCM Management Team.
• Identify files that need reactivation when raised payer issues are resolved, and triage files to the appropriate departments, and provide direction regarding actions to take for reimbursement.
• Maintain a standard review and audit process for all files entering a suspended/inactive status to ensure appropriate steps have been taken before exhausting reimbursement efforts.
• Analyze and work various revenue reports, including, but not limited to "claim validation", "return billing report", to ensure all reimbursement procedures were followed, and claims can be released to payers or funneled back into the reimbursement process or accounts are closed out in the appropriate manner.
• Contact patients/families/caregivers as needed to obtain current demographics, insurance, physician, and device usage, to ensure appropriate insurance reimbursement.
• Obtain appropriate documentation such as medical records, Medicare Advanced Beneficiary Notice (ABN), Terms Conditions Responsibility Form (TCR), and Patient Waiver Form as needed for reimbursement.

What you'll bring

• Associates degree is required. Bachelor degree or higher is preferred.
• 3+ years of industry experience, preferably in health insurance and/or durable medical equipment.
• Third party payer experience strongly preferred.
• Exceptional written, verbal, and interpersonal communications.
• Strong critical thinking and problem-solving skills.
• Ability to work independently as well as in a team environment.
• Possess the ability to manage time and prioritize critical priorities.
• Proficiency in Microsoft Office Software.
• Experience with Total Information Management System (TIMS) a benefit.

We understand compensation is an important factor as you consider the next step in your career. At Baxter, we are committed to equitable pay for all employees, and we strive to be more transparent with our pay practices. The estimated base salary for this position is $48,000 to $66,000 annually. The estimated range is meant to reflect an anticipated salary range for the position. We may pay more or less than of the anticipated range based upon market data and other factors, all of which are subject to change. Individual pay is based on upon location, skills and expertise, experience, and other relevant factors. For questions about this, our pay philosophy, and available benefits, please speak to the recruiter if you decide to apply and are selected for an interview.

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The successful candidate for this job may be required to verify that he or she has been vaccinated against COVID-19, subject to reasonable accommodations for individuals with medical conditions or religious beliefs that prevent vaccination, and in accordance with applicable law.

Equal Employment Opportunity

Baxter is an equal opportunity employer. Baxter evaluates qualified applicants without regard to race, color, religion, gender, national origin, age, sexual orientation, gender identity or expression, protected veteran status, disability/handicap status or any other legally protected characteristic.

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Pay Transparency Policy

Reasonable Accommodations

Baxter is committed to working with and providing reasonable accommodations to individuals with disabilities globally. If, because of a medical condition or disability, you need a reasonable accommodation for any part of the application or interview process, please click on the link here and let us know the nature of your request along with your contact information.

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