PFS Specialist II

Iberia Medical Center (IMC) in New Iberia, LA is looking for team members who will help advance our vision to be the premier hospital of choice for patients, physicians, and employees. We've been caring for our community for over 60 years and offer many diverse career paths. Our new employees experience opportunities to learn and grow while caring for their families, friends, and neighbors.

About the role

This is a full-time position responsible for resolving all unpaid claims including but not limited to Commercial Insurance, Medicare, Medicare Replacement, Workman’s Comp, Hospice, VA, or Medicaid claims assigned by the PFS Assistant Manager. Provides back-up coverage to the Commercial, Medicare, and Medicaid Billers for billing or follow-up and to the Credit Balance Clerk as needed.

Responsibilities

• Resolves all assigned unpaid claims including but not limited to Commercial, Medicare, Medicare Replacement, Workman’s Comp, VA, Hospice, or Medicaid claims on the Monthly ATB reports and otherwise ensures that all these accounts are paid in a timely manner.
• Provides back-up coverage to the Commercial, Medicare, and Medicaid Billers for billing or follow-up as needed.
• Provides back-up coverage to the Credit Balance Clerk as needed.
• Ensures that all unresolved issues for accounts on the Medicare, Medicaid, and/or Commercial remittance advices are resolved on a weekly basis.
• Ensures that any assigned denials, requests for refiles, etc., that are received from insurance companies are followed-up on within 3-5 business days.
• Edits and otherwise prepares all Medicaid Claims to be filed on a daily basis; ensures that the transmission of claims is completed and received by Medicaid.
• Assists with completion of the Medicare Credit Balance quarterly report.
• Initial billing of all claims generated within the inpatient and outpatient Behavioral Health facility.
• Assists with Contract Management underpayment appeals and research.

Requirements

• High School Graduate or equivalent.
• 2-3 years previous hospital business office experience related to the filing and collection of Commercial and Medicaid claims.

Schedule

8:00 am to 4:30 pm, Monday through Friday.

Benefits

• Great medical benefit plan.
• Early access to earned wages.
• Participation in robust state pension plan.
• Dental, vision, life insurance, and disability coverage.