PFS Collection Specialist

Confluent Health LLC; California; Remote; USD 42,000 - 64,000; Full time

Job summary

Confluent Health LLC is seeking a detail‑oriented Accounts Receivable/Collections Specialist to manage commercial, government, and patient balances under established revenue cycle policies. This remote role emphasizes accuracy, timely follow‑up, and clear communication with payors and patients to maximize reimbursement.

You will review EOBs, file insurance claims, appeal denials, and arrange patient payment plans while maintaining confidentiality and collaborating with the revenue cycle team to

Qualifications

• High school diploma or GED required.
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Responsibilities

• Monitor outstanding balances and determine next steps in the collection process.

Skills

Attention to detail

Problem-solving

Time management

Communication skills

Teamwork

Independence

Organizational skills

Discretion/confidentiality

Education

High school diploma or GED

Tools

Windows-based technologies

Job description

Overview

Position Summary: Responsible for collecting commercial, government, and patient balances by following the approved processes, policies and procedures set by the revenue cycle department.

Responsibilities

Remote position

Essential Functions:

• Monitors outstanding account balances to determine the next step in the collection process.
• Follows up on claims and claim denials to ensure maximum reimbursement for services provided.
• Reviews accounts receivable activities and calls on outstanding balances or claims.
• Generates appropriate paperwork, including insurance claim forms (original and re-filed) and collection letters.
• Reviews insurance payments (Explanation of Benefits – EOB’s) to determine whether reimbursement is accurate. Navigate portals to send claims for adjudication.
• Investigates and appeals denied or underpaid claims.
• Responds to all inquiries received from patients and payors either by telephone or written request.
• Tracks and resolves discrepancies.
• Follows-up on unpaid insurance claims after denial to obtain settlement of claim.
• Audit insurance and patient accounts to determine whether a refund is needed.
• Promptly and courteously responds to all inquiries received from payors and patients either by telephone or written request.
• Provides clear communication and customer service on collection issues to external customers and internal business partners.
• Helps patients develop patient payment plans.
• Identifies patterns and trends that indicate a potential issue.
• Adheres to all policies and procedures in performing job duties and responsibilities while supporting a culture of high quality and great customer service.
• Performs other duties that may be necessary or in the best interest of the organization.
• Submits billing data to insurance providers.
• Participates in continuing educational activities relative to assigned duties and responsibilities.

Qualifications

Qualifications/Skills:

• High school diploma or GED required.
• Computer proficiency and experience in windows-based technologies
• Ability to be discrete and security confidential and sensitive information.
• Prior work experience in a medical office setting preferred.
• Excellent problem-solving skills, attention to detail, management of multiple tasks and the ability to do so independently.
• Ability to handle difficult situations with a positive attitude.
• Good interpersonal, oral and written communication skills.
• Strong organizational and time management skills.
• Ability to adhere to deadlines timely.
• Must be able to work as part of a team with peers and leadership within the organization.
• Must possess a high level of interpersonal skills including the ability to respond calmly and make rational decisions in stressful situations.