PFS Insurance Follow-Up Rep Ambulatory Denials

Banner Health; Kansas; Remote; USD 10,000 - 60,000; Full time

Job summary

A leading healthcare provider is seeking a PFS Insurance Follow-Up Representative to follow up on denials related to billing. This remote role requires experience in medical insurance and strong skills in Excel. The ideal candidate will be responsible for coordinating patient billing activities and ensuring timely reimbursements. Competitive pay range: $17.58 - $26.36/hour based on experience.

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

• Follow up with assigned payer for various denials.
• Coordinate patient billing and collection activities.
• Ensure reimbursement for services in a timely manner.

Skills

Medical Insurance AR

Microsoft Excel

Appeal letter writing

Education

High school diploma/GED

Job description

PFS Insurance Follow-Up Rep Ambulatory Denials

Estimated Pay Range: $17.58 - $26.36 / hour, based on location, education, & experience.

Department Name: Amb Billing & Follow Up

Work Shift: Day

Job Category: Revenue Cycle

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;
• 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

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:

• 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.
• 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.
• 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.
• 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.
• 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.
• Works as a member of the patient financial services team to achieve goals in days and dollars of outstanding accounts. Reduces Accounts Receivable balances.
• Uses systems to document and to provide statistical data, prepare issues list(s) and to communicate with payors accurately.
• Works independently under general supervision, following defined standards and procedures. Reports to a Supervisor or Manger. Uses critical thinking skills to solve problems and reconcile accounts in a timely manner.

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.

Preferred Qualifications:

Work experience with the Company’s systems and processes is preferred. Previous cash collections experience is preferred.

EEO Statement: EEO/Disabled/Veterans

Our organization supports a drug-free work environment.