PFS Representative
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Job Description
Remote PFS Representative managing payer denials, appeals, and accounts receivable for Banner Health. Supporting patient billing and reimbursement across approved U.S. states.
Responsibilities:
- Follow up with assigned payers on denials, including authorization and eligibility denials
- Coordinate and facilitate patient billing and collection activities
- Process payments, adjustments, claims, correspondence, refunds, denials, financial/charity applications, and/or payment plans
- Reconcile, balance, and pursue account balances, payments, and denials
- Research payments, denials, and accounts to identify short/overpayments, contract discrepancies, financial-class errors, and other issues
- Make appeals and corrections as necessary
- Build relationships with business units, hospital departments, and provider offices
- Identify payment trends and communicate solutions to internal and external customers
- Respond to incoming calls and make outbound calls to resolve billing, payment, and accounting issues
- Reduce accounts receivable balances and support patient financial services goals
- Document information in systems, provide statistical data, prepare issue lists, and communicate with payors
- Work independently under general supervision and report to a Supervisor or Manager
Requirements:
- Minimum of 1 year experience in Medical Insurance AR and/or Physician Fee for Service Billing
- Minimum of 1 year experience writing appeal letters for payer/payor denials
- Intermediate to Advanced skill level in Microsoft Excel
- High school diploma/GED or equivalent working knowledge
- Knowledge of patient financial services, financial, collecting services or insurance industry experience processes normally acquired over one or more years of work experience
- Ability to manage multiple tasks simultaneously with minimal supervision and to work independently
- Strong interpersonal, oral, and written communication skills
- Strong knowledge of common office software, word processing, spreadsheet, and database software
- Work experience with the Company's systems and processes preferred
- Previous cash collections experience preferred
- Additional related education and/or experience preferred
Benefits:
- Great Place To Work® Certification™ workplace
- Stimulating and rewarding careers
- Total rewards package
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