PFS Government A/R Specialist I-ABQ

Presbyterian Healthcare Services; Albuquerque (NM); On-site; USD 80,000 - 100,000; Full time

Job summary

A healthcare provider in Albuquerque is seeking a Government A/R Specialist I to manage insurance claims, resolve billing issues, and support patient financial services. The ideal candidate will have experience in insurance follow-up and strong communication skills. This role offers a competitive hourly wage and comprehensive benefits.

Benefits

Medical, dental, and vision coverage

Employee Wellness Rewards Program

Life insurance and disability coverage

Qualifications

• Minimum one year experience in insurance follow-up, billing, and collections.
• Practical experience or specialized training in direct patient care.
• Proficient knowledge of ICD-10, HCPCS, CPT codes.

Responsibilities

• Prepare, process, and submit accurate insurance claims.
• Resolve claim edits and billing issues.
• Perform A/R follow-up in compliance with regulations.

Skills

Insurance follow-up

Billing and collections

Effective communication

Problem-solving

Attention to detail

Education

High school degree or GED

Tools

Epic

nThrive

Microsoft Office Suite

Job description

Overview

PFS Government A/R Specialist I at Presbyterian Healthcare Services.

Requisition ID: 2025-49093 • Category: Patient Financial Services • Location: Rev Hugh Cooper Admin Center, Albuquerque, NM • Minimum Offer: USD $15.87/Hr. • Maximum Offer: USD $23.04/Hr.

Job location and compensation details are provided with this posting. The role is based at the Rev Hugh Cooper Admin Center in Albuquerque, NM, and pays within the stated range.

Responsibilities

• Prepare, process, and submit accurate insurance claims for all payer types

• Resolve claim edits, billing issues, and denials to ensure clean claim submission

• Perform A/R follow-up, appeals, and reconsiderations in compliance with payer and CMS regulations

• Communicate with insurance companies, patients, and employers to obtain required information

• Manage and document work queues to meet performance targets

• Provide requested medical records or documentation to support claim processing

• Stay informed of billing and reimbursement procedure changes; identify trends and escalate issues

• Maintain compliance with HIPAA, confidentiality, and PHS policies

• Collaborate with team members and leadership to support continuous process improvement

Ideal Candidate

The preferred candidate will have practical experience or specialized training in direct patient care, showcasing strong clinical skills and a dedication to empathetic support.

Qualifications

• High school degree or GED required, short-term training on insurance collections and claims processing. Minimum one year experience in insurance follow-up, billing, and collections.

• Demonstrated ability to communicate effectively via telephone and in writing and be computer literate.

• Passionate about contributing to an organization focused on continuously improving patient experiences and the health of our community.

• Experience working in patient accounting/ billing system or claims clearinghouse (e.g., Epic or nThrive) preferred.

• Proficient with Microsoft Office Suite. Strong organizational, problem-solving, verbal and written communication skills; attention to detail; ability to interact with other functional areas and management teams.

• Strong work ethic and ability to work effectively in a team environment.

• Ability to prioritize and manage a high-volume workload.

• Ability to work in a fast-paced environment with changing payer regulations.

• Proficient knowledge of ICD-10, HCPCS, CPT codes, Revenue Codes, UB04/HCFA 1500 claim forms; understanding of electronic processing of 837 and 835.

• Proficient knowledge of Coordination of Benefits and Medicare MSPQ.

• Knowledge of various payer requirements and claim submission processes for major carriers.

• Basic knowledge of revenue cycle processes.

• Ability to provide a confidential home-office workspace; minimum broadband speed of 25x10 Mbps required.

• HIPAA-compliant, distraction-free workspace.

Benefits

About Presbyterian Healthcare Services: Presbyterian offers a comprehensive benefits package (medical, dental, vision, disability coverage, life insurance, and optional voluntary benefits).

The Employee Wellness Rewards Program encourages health-enhancing activities with rewards.

Presbyterian is a mission-driven, not-for-profit healthcare system serving New Mexico; founded in 1908 with nine hospitals, a statewide health plan, and a growing medical group. AA/EOE/VET/DISABLED. PHS is drug-free and tobacco-free with smoke-free campuses.

Note on Compensation

Maximum offer for this position is up to USD $23.04/Hr.