Patient Financial Services Associate II

Abbott Laboratories; United States; Remote; USD 23,000 - 47,000; Full time

Job summary

Abbott Laboratories is seeking a Patient Financial Services Associate for a remote role in the United States. You will process claims, appeals, denials, and statements with accuracy and efficiency, leveraging Epic and other software to resolve payor issues and ensure optimal AR outcomes.

The role requires knowledge of medical billing, insurance processing, and HIPAA compliance. You will work across commercial and government plans, communicate findings to ancillary departments, and maintain

Qualifications

• Minimum qualifications include a high school diploma or GED and 2 years in medical billing or insurance processing.
• Extensive knowledge of government, managed care, and commercial insurance claim submission requirements.
• Knowledge of medical terminology and health insurance terms.
• Experience with EHR systems and Epic is preferred.

Responsibilities

• Verify patient insurance eligibility and update accounts in Epic.
• Interact with insurances/payors to obtain authorizations and document policies.
• Research missing or erroneous information on accounts using portals and outreach.
• Review/edit claims and appeals before submitting to clearinghouses.
• Resolve claim issues per payor rules with independence.
• Correct rejected claims from scrubbers or payors and follow up on denials.

Skills

Medical billing

Insurance processing

Attention to detail

HIPAA compliance

Epic EHR

Education

High School Diploma or GED

Associate degree or medical billing cert

Tools

Epic

Job description

Company Overview

Abbott is a global healthcare leader that helps people live more fully at all stages of life. Our portfolio of life-changing technologies spans the spectrum of healthcare, with leading businesses and products in diagnostics, medical devices, nutritionals and branded generic medicines. Our 122,000 colleagues serve people in more than 160 countries.

Position Overview

The Patient Financial Services Associate position (PFS) is responsible for the accurate and timely processing of claims, appeals, denials, and statements. A PFSAII demonstrates medical insurance knowledge by resolving billing discrepancies, eligibility, denials, appeals, and aged unpaid claim follow up for commercial, government, and plan coverage for optimal Account Receivable (AR) outcomes. PFSAII communicates insurance information to ancillary departments and ensuring appropriate coverage by utilizing Epic, external portals, and other software. Reviews and resolves payor denials, appeals, and claims with no response from the payors via portals, calls to payors, and system investigations to ensure accurate claim resolution. Reads and understands explanations of payments to resolve back end claim resolution. This position is remote.

Essential Duties

• Independently determine initial or ongoing patient insurance eligibility verification, investigate, and correct accounts within Epic; including updates to patient demographics, financial information, and guarantor information.


• Ability to interact with various insurances and third‑party payors accurately and timely to ensure authorization is obtained and documented based on internal and external policies and regulations.


• Research missing or erroneous information on accounts using various portals and other resources; including outreach and identification of unknown payors.


• Review/edit claims and appeals prior to submitting to clearinghouse.


• Analyze, research, and resolve claim issues applying federal, state, and payor rules and procedures with a high degree of independence.


• Correct rejected claims from the claim’s scrubber, clearinghouse, or payor.


• Review explanations of payments, analyzes, and completes appropriate steps for all denials by appropriately identifying claim resolution next steps; including appealing, writing off, or sending statements.


• Investigate payor underpayments.


• Follow up with payors via phone on unpaid aging claims.


• Reviews denials and determines appropriate next actions; such as sending appeals or patient statements.


• Provide any supporting documentation needed by insurance payor.


• Perform accurate and timely write-offs following identification of uncollectible accounts adhering to policies and guidelines.


• Participate in regularly scheduled team meetings sharing denial trends specific to claim requirements to enhance front end claim edits to facilitate first pass resolution.


• Contribute ideas for workflows and best practices to maximize opportunities for performance, process, and net revenue collections improvement.


• Provide ad‑hoc support, as necessary, within the department (i.e., special projects, provide support due to outages/high volume).


• Complete position responsibilities within the appropriate time frame while adhering to quality standards.


• Stay current with relevant medical billing regulations, rules, and guidelines.


• Maintain strictest confidentiality; adheres to all HIPAA guidelines/regulations.

Minimum Qualifications

• High School Diploma or General Education Degree (GED).


• 2 years of experience in medical billing, claims, and/or insurance processing.


• Extensive and current working knowledge of government, managed care, and commercial insurances claim submission requirements, reimbursement guidelines, and codes.


• Knowledge of medical terminology and/or health insurance terms.


• Knowledge of EHR operating systems and work involving electronic records.


• Proficient in computer systems and keyboarding skills.


• Demonstrated strong attention to detail and focus on quality output.


• Demonstrated ability to perform the Essential Duties of the position with or without accommodation.


• Authorization to work in the United States without sponsorship.

Preferred Qualifications

• Related Associate degree or medical billing certification.


• 4+ years of experience in medical or insurance billing field.


• Experience with Epic or other EHR application.

Compensation

The base pay for this position is $17.00 – $34.00/hour In specific locations, the pay range may vary from the range posted.

Job Details

JOB FAMILY: Accounts Payable & Receivables, Credit & Collection, & Payroll

DIVISION: ONCO Cancer Diagnostics

LOCATION: United States of America : Remote ADDITIONAL LOCATIONS:

WORK SHIFT: Standard TRAVEL: No MEDICAL SURVEILLANCE: No SIGNIFICANT WORK ACTIVITIES: Continuous sitting for prolonged periods (more than 2 consecutive hours in an 8 hour day), Keyboard use (greater or equal to 50% of the workday)

Equal Opportunity

Abbott is an Equal Opportunity Employer of Minorities/Women/Individuals with Disabilities/Protected Veterans.

EEO is the Law link - English: http://webstorage.abbott.com/common/External/EEO_English.pdf

EEO is the Law link - Espanol: http://webstorage.abbott.com/common/External/EEO_Spanish.pdf

About Abbott

Abbott is about the power of health. For more than 135 years, Abbott has been helping people reach their potential — because better health allows people and communities to achieve more. With a diverse, global network serving customers in more than 160 countries, we create new solutions — across the spectrum of health, around the world, for all stages of life. Whether it’s next‑generation diagnostics, life‑changing devices, science‑based nutrition, or novel reformulations, we are advancing some of the most innovative and revolutionary technologies in healthcare, helping people live their best lives through better health. The people of Abbott come to work each day with relentless energy, enthusiasm and a promise to enhance the health and well‑being of millions of people. They push the boundaries to help manage and treat some of life’s greatest health challenges. We invite you to explore opportunities at Abbott, to see if your talents and career aspirations may fit with our openings. An equal opportunity employer, Abbott welcomes and encourages diversity in our workforce.