Claims Resolution Manager, Hybrid, Metro Square
Date Posted: Jul 29, 2026
Status: Full time
Shift Details: N/A
Job Summary
Baptist Health is looking to add a Claims Resolution Manager in our Hospital Billing Department at Baptist Metro Square. This is a Full Time and Hybrid opportunity.
Baptist Jacksonville is a Magnet™ designated hospital, the gold standard for excellence in patient care. We serve families throughout the area with high-quality, comprehensive care for every stage of life.
As a Claims Resolution Manager, you will be responsible for:
- Leads a team dedicated to physician billing claims follow up who can determine why a claim is underpaid or denied taking the necessary steps to resolve the claim to payment.
- The manager possesses critical thinking skills and the ability to implement processes that improve efficiencies, optimize team members strengths, and consider system abilities or limitations.
- There is a focus on quality claims resolution rather than claim touch or productivity and enhancing team members skillsets and intrinsic motivation to find a solution to claim payment.
- The manager has experience in both Managed Care and government payers and is capable of distinguishing internal process gaps versus payer related issues.
- Duties include strategic planning for staffing needs and cross training, workload distribution, and team member development such as mentorship, effective delegation, and open communication.
- The manager is driven to find solutions and confident in making decisions based on pertinent information and metrics.
Experience Requirements:
3-5 Years - Denials Management Experience (Required)
3-5 Years - Experience Hospital Claims Follow-Up Experience (Required)
3-5 Years - Leadership Experience (Required)
3-5 Years - Payer Strategy Experience (Required)
1-2 Years - Process Improvement Experience (Required)
5+ Years - Relevant equivalent experience in lieu of education (Required)
3-5 Years - Appeals Management Experience (Required)
Education & Credential Requirements:
Bachelor's Degree - Required
This Claims Resolution Manager will be located at Baptist Metro Square. If you are interested in this Full-Time opportunity, please apply now
Education Required
BS
Experience
- Appeals Management Experience
- Relevant equivalent experience in lieu of education
- Process Improvement Experience
- Payer Strategy Experience
- Leadership Experience
- Hospital Claims Follow Up Experience
- Denials Management Experience
License and Certification
- Driver's License - DMV
Location
Metro Square
3563 Philips Hwy
Jacksonville, Florida, 32207
About Baptist Health
Chosen as the area's “Most Preferred” healthcare provider every year since 1990 according to the annual National Research Corporation study of Jacksonville area residents, Baptist Health ranks highest in the categories of Best Doctors, Best Nurses, Best Quality and Best Reputation.