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PFS Specialist II

Baton Rouge General Medical Center

Analyze and follow up on outstanding account balances to ensure timely and accurate reimbursement.

Responsibilities include:

  • Process claims in Ambulatory Claims Manager (ACM), resolving invalid or rejected claims within 5 days and documenting status
  • Process hard copy claims for payment
  • Attach EOBs for secondary and 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

Qualifications include:

  • 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

Benefits and perks mentioned include:

  • Comprehensive benefits program for employees and their families
  • Professional development and support
  • Generous paid time off
  • Flexible positions
  • Baton Rouge General Fit! program
  • Work for a nationally and locally recognized healthcare employer

Location

Baton Rouge, Louisiana, US

Employment Type

Not specified

Experience Level

Associate

Remote work allowed

No

Posted

2 weeks ago

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