PFS CBO Insurance Followup Ambulatory Denials

Banner Health Corporate; Tucson (AZ); Hybrid; USD 25,000 - 38,000; Full time

Job summary

Banner Health is seeking an Amb Billing & Follow Up professional to support our remote team. The role focuses on medical insurance AR, denials, and follow-up across multiple payer scenarios with strong Excel skills.

The ideal candidate will have at least 1 year of experience in related billing, appeals letters, and a demonstrated ability to manage multiple tasks with accuracy. This remote position can serve residents in listed states with training and clear performance goals.

Qualifications

• Minimum of 1 year experience in Medical Insurance AR and/or Physician Fee for Service Billing.
• Minimum of 1 year experience writing appeal letters for payer/payor denials.
• Intermediate to Advanced skill level in Microsoft Excel.

Responsibilities

• Coordinate patient billing and collection activities across assigned areas.
• Research denials and payer remits to maximize reimbursement.
• Prepare and process payments, adjustments, denials, and payment plans.
• Provide excellent customer service to patients and internal stakeholders.
• Maintain accurate documentation and communicate with payors and staff.

Skills

Medical Insurance AR

Appeal letters

Microsoft Excel

Tools

Microsoft Excel

Job description

Department Name: Amb Billing & Follow Up Work Shift: Day Job Category: Revenue Cycle Innovation and highly trained staff. Banner Health recently earned Great Place To Work® Certification™. This recognition reflects our investment in workplace excellence and the happiness, satisfaction, wellbeing and fulfilment of our team members. Find out how we’re constantly improving to make Banner Health the best place to work and receive care.

The PFS Insurance Follow-Up Representative (Ambulatory Denials) is responsible for following up with assigned payer for various denials, such as no authorization, eligibility denials, etc. This position is a higher-level PFS role, as it does range across all groups of patients and all types of provider specialties. Experience within medical insurance accounts receivable (AR) and physician fee-for-service billing is ideal.

Location: Remote Schedule: Monday-Friday, varying shifts 6am-6pm after successful completion of training program.

Ideal Candidate: Minimum of 1 year experience in Medical Insurance AR and/or Physician Fee for Service Billing clearly reflected in uploaded resume; Minimum of 1 year experience writing appeal letters for payer/payor denials; Intermediate to Advanced skill level in Microsoft Excel.

This can be a remote position if you live in the following state(s) only: 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

Within Banner Health Corporate, you will have the opportunity to apply your unique experience and expertise in support of a nationally-recognized healthcare leader. We offer stimulating and rewarding careers in a wide array of disciplines. Whether your background is in Human Resources, Finance, Information Technology, Legal, Managed Care Programs or Public Relations, you'll find many options for contributing to our award-winning patient care.

POSITION SUMMARY

This position coordinates and facilitates patient billing and collection activities in one or more assigned areas of billing, payment posting, collections, payor claims research, and other accounts receivable work. Works as a member of a team to ensure reimbursement for services in a timely and accurate manner.

CORE FUNCTIONS

1. May be assigned to process payments, adjustments, claims, correspondence, refunds, denials, financial/charity applications, and/or payment plans in an accurate and timely manner, meeting goals in work quality and productivity. Coordinates with other staff members and physician office staff as necessary ensure correct processing.
2. As assigned, reconciles, balances and pursues account balances and payments, and/or denials, working with payor remits, facility contracts, payor customer service, provider representatives, spreadsheets and the company’s collection/self-pay policies to ensure maximum reimbursement.
3. May be assigned to research payments, denials and/or accounts to determine short/over payments, contract discrepancies, incorrect financial classes, internal/external errors. Makes appeals and corrections as necessary.
4. Builds strong working relationships with assigned business units, hospital departments or provider offices. Identifies trends in payment issues and communicates with internal and external customers as appropriate to educate and correct problems. Provides assistance and excellent customer service to these internal clients.
5. Responds to incoming calls and makes outbound calls as required to resolve billing, payment and accounting issues. Provides assistance and excellent customer service to patients, patient families, providers, and other internal and external customers.
6. Works as a member of the patient financial services team to achieve goals in days and dollars of outstanding accounts. Reduces Accounts Receivable balances.
7. Uses systems to document and to provide statistical data, prepare issues list(s) and to communicate with payors accurately.
8. Works independently under general supervision, following defined standards and procedures. Reports to a Supervisor or Manager. Uses critical thinking skills to solve problems and reconcile accounts in a timely manner. External customers include all hospital patients, patient families and all third party payers. Internal customers include facility medical records and patient financial services staff, attorneys, and central services staff members.

MINIMUM QUALIFICATIONS

• High school diploma/GED or equivalent working knowledge.
• Requires knowledge of patient financial services, financial, collecting services or insurance industry experience processes normally acquired over one or more years of work experience.
• Requires the ability to manage multiple tasks simultaneously with minimal supervision and to work independently.
• Requires strong interpersonal, oral, and written communication skills to effectively interact with a wide range of audiences.
• Strong knowledge in the use of common office software, word processing, spreadsheet, and database software are required.

PREFERRED QUALIFICATIONS

• Work experience with the Company’s systems and processes is preferred.
• Previous cash collections experience is preferred.
• Additional related education and/or experience preferred.

Estimated Pay Range

Estimated Pay Range: $18.38 - $27.56 / hour Banner Health is committed to pay equity and transparency. The posted compensation range is a reasonable estimate that extends from the lowest to the highest pay Banner Health in good faith believes it might pay for this particular job, based on the circumstances at the time of posting. This range is based on possible base salaries and does not include the value of our total rewards package. Actual pay determined at offer will be based on years of relevant work experience, education, certifications, skills, and geographic location, along with a review of current employees in similar roles to ensure pay equity is achieved and maintained.

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Banner Health is one of the largest, nonprofit health care systems in the country and the leading nonprofit provider of hospital services in all the communities we serve. Throughout our network of hospitals, primary care health centers, research centers, labs, physician practices and more, our skilled and compassionate professionals use the latest technology to make health care easier, so life can be better. The many locations, career opportunities, and benefits offered at Banner Health help to make the Banner Journey unique and fulfilling for every employee. We are proud to offer a comprehensive benefit package for all benefit‑eligible positions. Please visit our Benefits Guide for more information.