Government A/R Specialist I – Claims & Denials

Presbyterian Healthcare Services; United States; Teletrabalho; USD 23 000 - 37 000; Tempo integral

Resumo da oferta

Presbyterian Healthcare Services is seeking a PFS Government A/R Specialist I to accurately submit insurance claims for all payer types and to follow up on payer edits. This on-site role at the Reverend Hugh Cooper Administrative Center involves conducting denial management, appeals, and AR activities while maintaining HIPAA compliance.

The ideal candidate has a high school diploma or GED and at least one year in insurance follow-up, billing, or collections, with proficiency in Epic or nThrive

Qualificações

• High school degree or GED required with basic insurance knowledge.
• Experience in insurance follow-up, billing and collections preferred.
• Strong communication via phone and writing; detail-oriented.

Responsabilidades

• Submit accurate insurance claims for all payer types per policy and payer rules.
• Resolve pre-billing edits to ensure compliant, accurate billing.
• Refer accounts with claim edits for further review to ensure clean submissions.
• Monitor work queues to meet performance indicators and deadlines.
• Contact insurance companies, patients, and employers for required info.
• Submit electronic and paper claims with necessary attachments and forms.
• Follow up on denials and prepare appeals when needed.
• Maintain HIPAA compliance and confidentiality at all times.

Conhecimentos

Insurance follow-up

Billing

Accounts receivable

Communication skills

HIPAA compliance

Formação académica

High school degree or GED

Ferramentas

Epic

nThrive

FISS/DDE

Presbyterian Portal

Payer portals

MS Office

Descrição da oferta de emprego

Presbyterian Healthcare Services is seeking a PFS Government A/R Specialist I to accurately submit insurance claims for all payer types and to follow up on payer edits. This on-site role at the Reverend Hugh Cooper Administrative Center involves conducting denial management, appeals, and AR activities while maintaining HIPAA compliance.

The ideal candidate has a high school diploma or GED and at least one year in insurance follow-up, billing, or collections, with proficiency in Epic or nThrive