PFS Quality Analyst

Freddie Mac; United States; Remote; USD 60,000 - 80,000; Full time

Job summary

An established industry player is seeking a PFS Quality Assurance Specialist to enhance healthcare services. This role involves quality monitoring and analysis, ensuring compliance with billing requirements, and optimizing revenue cycle processes. You will collaborate with various departments to analyze patient accounts, recommend adjustments, and provide excellent customer service. Join a mission-driven organization dedicated to improving healthcare outcomes while enjoying the flexibility of remote work options across multiple states. If you're ready to make a significant impact in the healthcare sector, this is the opportunity for you.

Qualifications

• 3-5 years in patient financial services or accounting with medical terminology knowledge.
• Strong organizational skills and proficiency in software applications.

Responsibilities

• Analyze patient accounts for consistent reimbursement and recommend contract adjustments.
• Identify system processing issues and assist with testing to prevent workflow disruptions.

Skills

Mathematical Skills

Customer Service

Communication Skills

Organizational Skills

Education

Bachelor's Degree

Job description

Department Name:

Acute Billing & Follow Up-Corp

Work Shift:

Day

Job Category:

Revenue Cycle

Estimated Pay Range:

$24.32 - $36.48 / hour, based on location, education, & experience. In accordance with State Pay Transparency Rules.

Join a rewarding career that fits your life. Those who have joined the Banner mission come from all walks of life, united by the goal: Make health care easier, so life can be better. If you want to be part of improving health care, apply today.

About Revenue Integrity:

Revenue Integrity is a national focus for sound financial practices, compliance, and optimal reimbursement across all patient care continuums. It encompasses Charge Capture, Pre-bill, Post-bill, and Monitoring (Auditing). The team utilizes technology to enhance outcomes, focusing on high dollar accounts, denials, A/R days, and cash flow, collaborating with Billing, Coding, CDM Services, and others to optimize reimbursement.

Position Overview:

As a PFS Quality Assurance Specialist, you will analyze and audit registration functions supporting Patient Financial Services to ensure billing compliance. You will identify system issues, facilitate credit balances and underpayments, analyze data, and support revenue minimization efforts. You will also assist with compliance reporting to insurance carriers and third parties.

Core Responsibilities:

1. Analyze patient accounts for consistent reimbursement, recommend contract adjustments.
2. Correct inaccurate accounts, process refunds, adjustments, and overpayment letters accurately and promptly.
3. Identify and recommend corrections for system processing issues, assist with testing.
4. Use multiple systems to generate data and communicate with payers, attend payer meetings.
5. Build relationships across departments, analyze trends, and prepare reports for management and auditors.
6. Reconcile payments, work with remits and contracts to maximize reimbursement.
7. Respond to calls regarding credit balances, providing excellent customer service.
8. Train staff, improve processes, and lead projects as needed.
9. Work independently, using critical thinking to solve problems, report to supervisor or manager.

Minimum Qualifications:

Bachelor's degree or equivalent experience. Strong math skills. 3-5 years in patient financial services or accounting. Knowledge of medical terminology, insurance laws, billing procedures, Medicare, and AHCCCS regulations. Organizational skills, customer service, proficiency in office software, ability to analyze data, teamwork, and deadline management.

Preferred Qualifications:

Experience with billing/collections systems, leadership, training, or clinical background. Additional education or experience is a plus.

EEO and Privacy:

EEO/Female/Minority/Disability/Veterans. Supports a drug-free workplace. Privacy Policy applies.