PFS Specialist II

Responsibilities

• 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
• 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

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

Why You'll Love Working With Us

• A comprehensive benefits program for you and your family
• Professional development and support
• Variety of 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

Perks

• Check out our employee perks

About the Role

Baton Rouge General is 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.