PFS Specialist I

IBERIA MEDICAL CENTER; New Iberia (LA); On-site; USD 35,000 - 52,000; Full time

Job summary

Iberia Medical Center is seeking a PFS Specialist I to support timely filing and collection of insurance claims and to help resolve patient requests. This role reports to the PFS Assistant Manager and contributes to accurate accounting of payor reimbursements.

The ideal candidate offers 2-3 years of hospital business office experience, with thorough knowledge of insurance reimbursement methods and a high school diploma or equivalent.

Qualifications

• 2-3 years hospital business office experience related to filing and collection of insurance claims.
• Must have thorough knowledge of insurance reimbursement methods.

Responsibilities

• Ensures that designated Medicaid, Commercial, Workman Compensation or Medicare insurance claims are filed to the insurance company in a timely and accurate manner.
• Ensures that any denials, requests for re-files, etc., that are received from the insurance company are followed-up on within 3-5 business days.
• Ensures that all monies due from insurance companies are received within acceptable timeframes, and in accordance with contractual payor arrangements.
• Assists in helping to resolve any patient requests/issues, and ensures that all actions taken on account are thoroughly noted in the computer system.
• Completes Medicare Credit Balance report timely and correctly on a quarterly basis if applicable.

Skills

Insurance claims processing

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.