Government Claims A/R Specialist I

Presbyterian Healthcare Services; Albuquerque (NM); On-site; USD 23,000 - 37,000; Full time

Benefits offered by this job

Benefits package

Wellness program

Job summary

Presbyterian Healthcare Services in Albuquerque, NM seeks a Government Accounts Receivable Specialist I to accurately submit insurance claims for all payer types, including Government payers, using our claims clearinghouse and patient accounting systems.

The role requires researching payer edits, resolving denials, and performing A/R follow-up, appeals, and timely claim submissions in compliance with CMS and state regulations. Strong communication and teamwork are essential.

Qualifications

• Minimum one year experience in insurance follow-up, billing, and collections.
• Demonstrated ability to communicate effectively via telephone and in writing; computer literate.
• Experience with payer portals or claims clearinghouses preferred.

Responsibilities

• Prepares, processes, and files accurate and timely insurance claims for all payer types.
• Resolve prebilling edits for compliant and accurate billing.
• Refer accounts with claim edits to appropriate departments for review to ensure clean claim submission.
• Review and resolve work queues to meet KPIs.
• Contact insurance companies, patients, and employers to obtain required information for submission.

Skills

Insurance follow-up

Billing and collections

Communication skills

Education

High school diploma or GED

Tools

Epic

nThrive

FISS/DDE

Provider Portals

Microsoft Office Suite

Job description

Presbyterian Healthcare Services in Albuquerque, NM seeks a Government Accounts Receivable Specialist I to accurately submit insurance claims for all payer types, including Government payers, using our claims clearinghouse and patient accounting systems.

The role requires researching payer edits, resolving denials, and performing A/R follow-up, appeals, and timely claim submissions in compliance with CMS and state regulations. Strong communication and teamwork are essential.