PFS Representative, CBO, Ambulatory Billing Follow-up, Medicare

This is a fully remote position, open to applicants in Alabama, +35 more states.

📋 Description

• Follow up with designated payers concerning denials, including those related to authorization and eligibility.

• Coordinate and manage patient billing and collection activities.

• Handle payments, adjustments, claims, correspondence, refunds, denials, financial/charity applications, and payment plans as assigned.

• Reconcile, balance, and pursue outstanding account balances, payments, and denials.

• Investigate payments, denials, and accounts to uncover short/overpayments, contract discrepancies, financial class issues, and errors.

• Make necessary appeals and corrections.

• Develop working relationships with business units, hospital departments, and provider offices.

• Identify trends in payment issues and effectively communicate with both internal and external customers.

• Respond to inbound calls and initiate outbound calls to address billing, payment, and accounting concerns.

• Collaborate with the patient financial services team to decrease accounts receivable balances and meet outstanding-account objectives.

• Document information in systems, provide statistical data, prepare issue lists, and communicate accurately with payers.

• Work autonomously under general supervision and report to a Supervisor or Manager.

⛳️ Requirements

• At least 1 year of experience in Medical Insurance Accounts Receivable (Medicare experience preferred) and/or Physician Fee for Service Billing.

• A minimum of 1 year of experience in drafting appeal letters for payer denials.

• Intermediate to advanced proficiency in Microsoft Excel.

• Residency in one of the approved states: AL, AK, AR, AZ, CA, CO, FL, GA, IA, ID, IN, KS, KY, LA, MD, MI, MN, MO, MS, NC, ND, NE, NH, NY, NM, NV, OH, OK, OR, PA, SC, TN, TX, UT, VA, WA, WI, WV, WY.

• High school diploma/GED or equivalent working knowledge.

• Understanding of patient financial services, financial/collection services, or insurance industry processes.

• Ability to handle multiple tasks simultaneously with minimal supervision and work independently.

• Excellent interpersonal, oral, and written communication skills.

• Strong knowledge of common office software, including word processing, spreadsheet, and database applications.

• Prior work experience with the company's systems and processes is preferred.

• Previous experience in cash collections is preferred.

• Additional relevant education and/or experience is preferred.

🏝️ Benefits

• Great Place To Work® Certification™ workplace investment.

• Engaging and fulfilling career opportunities.

• Commitment to EEO/Disabled/Veterans in the workplace.

• Drug-free work environment.