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PFS Specialist II

Baton Rouge General Medical Center

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 escalate 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.
Requirements & Qualifications
  • 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
Benefits & Perks
  • Comprehensive benefits program for you and your family
  • Professional development and support
  • Generous paid time off
  • Flexible positions
  • Baton Rouge General Fit! program
  • Employee perks and resources for work-life balance

Location

Baton Rouge, Louisiana, US

Employment Type

Not specified

Experience Level

Intermediate Level

Remote work allowed

No

Posted

1 month ago

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