PFS Specialist II

Baton-Rouge-General; Baton Rouge (LA); On-site; USD 42,000 - 65,000; Full time

Job summary

Baton Rouge General is seeking a detail-oriented billing professional to support patient accounts and insurance collections. The role emphasizes accuracy, timely reimbursements, and adherence to HIPAA regulations. A strong customer-first approach helps ensure quality service for patients and providers.

The position requires experience in office operations and knowledge of Commercial Insurance, with opportunities for professional development and a comprehensive benefits program.

Qualifications

• High School Diploma or GED preferred.
• Detail-oriented with strong organizational skills.
• Experience in all phases of business office operations and insurance collections.
• Knowledge of Commercial Insurance and HIPAA regulations.
• Familiarity with medical records and financial data.

Responsibilities

• Analyze and follow up on outstanding account balances and establish payment arrangements.
• Process claims in ACM and resolve invalid/rejected claims within 5 days.
• Process hard copy claims for payment and attach EOBs.
• Ensure timely filing guidelines and fee schedule adherence.
• Maintain clear communications and create/update spreadsheets.
• Monitor for missing responses and escalate as needed.
• Investigate denial trends and assist management.
• Perform other duties as assigned.

Skills

Detail-oriented

Organizational skills

Investigative skills

Customer-first mindset

HIPAA compliance

Commercial Insurance knowledge

Billing and collections

Education

High School Diploma or GED

Job description

• Employee Type Full-Time

Are you passionate about ensuring financial accuracy and supporting patient care through effective account resolution?

What We're Looking For:

• Detail-oriented with strong organizational and investigative skills


• Self-motivated and proactive with a customer-first mindset


• Prior experience in all phases of business office operations and insurance collections


• High School Diploma or GED preferred


• Excellent understanding and knowledge of Commercial Insurance


• Familiarity with HIPAA regulations related to medical records and financial data


• Knowledge of safety practices relevant to billing and administrative roles

Why You'll Love Working With Us:

At Baton Rouge General our patients aren't the only people we take care of; we take care of our team too. We are proud to offer our employees the benefits and resources they need to be their best selves at work and at home.

• A comprehensive benefits program for you and your family


• Professional development and support


• Various employee perks include generous paid time off, flexible positions, and our Baton Rouge General Fit! program


• We are a nationally and locally recognized leader in quality and ranked one of the best healthcare employers in the state

Analyze and follow up on outstanding account balances and establish acceptable payment arrangements to ensure timely and accurate reimbursement.

• Process claims populating into Ambulatory Claims Manager (ACM), resolving invalid/rejected claims within 5 days, documenting status, and referring issues to management.


• Process hard copy claims for payment


• Attach EOBs for secondary/tertiary claims


• Ensure compliance with timely filing guidelines and fee schedule review


• Maintain practice responses to communications


• Create and respond to spreadsheets


• Monitor for missing responses and escaleate as needed


• Resolve "unable to bill" claims by verifying insurance information


• Investigate reports and monitor denial trends provided by management


• Perform other duties as assigned

What Sets BRG Apart:

At Baton Rouge General, we are a community of compassionate, caring individuals who set the bar when it comes to healthcare excellence. Our mission is to preserve and restore health, one person at a time. From clinical to non-clinical - what you do here matters.

With over 600 licensed beds between three campuses, Baton Rouge General offers the full spectrum of care from delivering newborns to providing end of life support through hospice. With clinics located throughout Baton Rouge and the surrounding areas, our physician group provides patients with comprehensive care and a full suite of specialties, including internal and family medicine and specialty care.