[Hiring] PFS Representative @Banner Health

Role Description

The PFS Insurance Follow-Up Representative (Ambulatory Denials, Medicare team) is responsible for following up with assigned payer for various denials, such as no authorization, eligibility denials, etc. This position is a higher-level PFS role, as it does range across all groups of patients and all types of provider specialties, as well as the full cycle of claim, from initial billing to zero balance.

• Coordinates and facilitates patient billing and collection activities in one or more assigned areas of billing, payment posting, collections, payor claims research, and other accounts receivable work.
• Works as a member of a team to ensure reimbursement for services in a timely and accurate manner.
• May be assigned to process payments, adjustments, claims, correspondence, refunds, denials, financial/charity applications, and/or payment plans in an accurate and timely manner.
• As assigned, reconciles, balances and pursues account balances and payments, and/or denials.
• May be assigned to research payments, denials and/or accounts to determine short/over payments, contract discrepancies, incorrect financial classes, internal/external errors.
• Builds strong working relationships with assigned business units, hospital departments or provider offices.
• Responds to incoming calls and makes outbound calls as required to resolve billing, payment and accounting issues.
• Works as a member of the patient financial services team to achieve goals in days and dollars of outstanding accounts.
• Uses systems to document and to provide statistical data, prepare issues list(s) and to communicate with payors accurately.
• Works independently under general supervision, following defined standards and procedures.

Qualifications

• Minimum of 1 year experience in Medical Insurance AR (Medicare experience preferred) and/or Physician Fee for Service Billing.
• Minimum of 1 year experience writing appeal letters for payer denials.
• Intermediate to Advanced skill level in Microsoft Excel.

Requirements

• High school diploma/GED or equivalent working knowledge.
• Requires knowledge of patient financial services, financial, collecting services or insurance industry processes normally acquired over one or more years of work experience.
• Requires strong interpersonal, oral, and written communication skills.
• Strong knowledge in the use of common office software, word processing, spreadsheet, and database software.

Benefits

• Estimated Pay Range: $18.02 - $27.03 / hour.
• Banner Health is committed to pay equity and transparency.