PFS Representative CBO Billing Follow-up Denials Mgt

Banner Health; Carson City (NV); Remote; USD 24,824 - 37,236; Full time

Job summary

A healthcare organization is seeking a PFS Representative for remote work to manage billing and collections. The ideal candidate will have experience in patient financial services, claim submissions, and be skilled in managing tasks independently. Responsibilities include processing claims, building relationships with payers, and ensuring timely reimbursement. Applicants should have a GED or diploma and be proficient in office software. This role offers full-time hours with a competitive pay range of $18.02 - $27.03 per hour depending on experience and location.

Qualifications

• 1 year of experience in patient financial services or medical claims.
• Ability to manage multiple tasks with minimal supervision.
• Knowledge of company systems and processes preferred.

Responsibilities

• Coordinate patient billing and collection activities.
• Process payments, adjustments, and claims accurately.
• Build strong relationships with internal and external customers.
• Handle incoming and outgoing customer inquiries.

Skills

Patient financial services experience

Claim submission and understanding EOBs

Knowledge of codes for claim processing

Strong interpersonal communication skills

Education

High school diploma/GED

Tools

Common office software

Job description

PFS Representative CBO Billing Follow-up Denials Mgt role at Banner Health

Estimated Pay Range: $18.02 - $27.03 / hour, based on location, education, & experience.

Department: 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™ and continues to improve workplace excellence.

Our PFS Representatives are crucial to the revenue cycle, reducing AR and improving patient experience post‑care. As a member of the PFS Rep CBO, Billing Follow‑up Denials Mgt team, you will work with insurance companies on behalf of patients to obtain payments for our acute and ambulatory teams. You’ll research and hold payers accountable to pay expected rates according to contracts, within allowed timeframes. Experience with different payers and various denial types (e.g., no authorization, eligibility denials) is a plus.

Schedule: Full time, Monday‑Friday, 8‑hour shifts, typically 8 am‑5 pm (depending on team)

Location: REMOTE (Banner provides equipment). Remote position available only in the following states: 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.

Ideal candidate:

• 1 year patient financial services (Central Billing) or medical claims experience.
• Experience submitting appeals and understanding EOBs.
• General knowledge of codes used for claim processing.

Position Summary

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

Core Functions

• Process payments, adjustments, claims, correspondence, refunds, denials, financial/charity applications, and payment plans accurately and timely.
• Reconcile, balance, and pursue account balances and payments or denials, working with payor remits, facility contracts, payor customer service, provider representatives, spreadsheets, and company collection/self‑pay policies to maximize reimbursement.
• Research payments, denials, and accounts to identify short/over‑payments, contract discrepancies, incorrect financial classes, internal/external errors, and make appeals and corrections as necessary.
• Build strong relationships with business units, hospital departments, or provider offices; identify payment issue trends and communicate with internal and external customers to educate and correct problems.
• Handle incoming calls and make outbound calls to resolve billing, payment, and accounting issues, providing excellent customer service to patients, families, providers, and other customers.
• Work independently under general supervision, following defined standards and procedures, to meet goals in days and dollars of outstanding accounts.
• Use systems to document, provide statistical data, prepare issue lists, and communicate with payors accurately.

Minimum Qualifications

High school diploma/GED or equivalent. Knowledge of patient financial services, financial/collecting services, or insurance industry processes normally acquired over one or more years of work experience.

Ability to manage multiple tasks simultaneously with minimal supervision, work independently, and possess strong interpersonal, oral, and written communication skills.

Strong knowledge of common office software (word processing, spreadsheets, database software) required.

Preferred Qualifications

• Experience with the Company’s systems and processes.
• Previous cash collections experience.

Additional Related Education & Experience Preferred

Any relevant education or experience not listed above.

Anticipated Closing Window: 2026-05-08

EEO Statement

EEO/Disabled/Veterans. Our organization supports a drug‑free work environment.