PFS Specialist I

Iberia Medical Center; New Iberia (LA); On-site; USD 36,000 - 54,000; Full time

Job summary

Iberia Medical Center in New Iberia, LA is seeking a PFS Specialist I to ensure designated claims (Commercial, Workman Comp, Medicaid Secondary or Medicare) are filed accurately and collected promptly. You will follow up on denials within 3-5 business days, document actions in the system, and prepare Medicare Credit Balance reports quarterly when applicable.

Requires 2-3 years of hospital business office experience and knowledge of reimbursement methods.

Qualifications

• Education: High school graduate or equivalent.
• Licensure/Certification: N/A.
• Training and Experience: 2-3 years hospital business office experience related to filing and collection of insurance claims.

Responsibilities

• Ensures designated Medicaid, Commercial, Workman Compensation or Medicare claims are filed timely and accurately.
• Follows up on denials and re-files within 3-5 business days.
• Ensures all monies due from payors are received within contractual timeframes.
• Assists with patient requests and documents actions in the computer system.
• Completes Medicare Credit Balance reports quarterly if applicable.

Skills

Hospital billing

Insurance claims

Revenue cycle

Education

High school diploma or equivalent

Job description

Iberia Medical Center (IMC) in New Iberia, LA is looking for team members who will help advance our vision to be the premier hospital of choice for patients, physicians and employees. We've been caring for our community for over 60 years and offer many diverse career paths. Our new employees experience opportunities to learn and grow while caring for their families, friends and neighbors.

IMC is currently looking for a PFS Specialist I, who ensures that designated claims for all Commercial,Workman Comp, Medicaid Secondary or Medicare insurance claims are filed tothe insurance company and collected on in a timely and accurate manner.Assists in helping to resolve any patientrequests/issues, as requested.Ensuresthat any and all actions taken on account are thoroughly noted in the computersystem. Completes Medicare Credit Balance report timely and correctly on aquarterly basis if applicable.

SCHEDULE

• Full-Time

JOB RELATIONSHIP

• WORKERS SUPERVISED: None
• SUPERVISED BY: PFS Assistant Manager

QUALIFICATIONS:

• Education:High school graduate or equivalent.
• Licensure/Certification: N/A.
• Training and Experience: 2-3 years previous hospital business officeexperience related to the filing and collection of insurance claims. Must have thorough knowledge of insurance reimbursementmethods.

PRINCIPLE TASKS, DUTIES, AND RESPONSIBILITIES:

• Ensures that all designatedMedicaid, Commercial, Workman Compensation or Medicare insurance claimsare filed to the insurance company in a timely and accurate manner.
• Ensures that anydenials, request for re-files, etc., that are received from the insurancecompany are followed-up on within 3-5 business days.
• Otherwise ensures thatall monies due from insurance companies are received within acceptabletimeframes, and in accordance with any contractual arrangements that may existwith payors.
• Assists in helping toresolve any patient requests/issues, as requested. Ensures that any and all actions taken onaccount are thoroughly noted in the computer system.
• CompletesMedicare Credit Balance report timely and correctly on a quarterly basis ifapplicable.