PFS Specialist II- Patient Financial Services

Company: Baton Rouge General

About the role

A detail-oriented professional with experience in Business Office operations and Insurance Collections is needed. Strong understanding of commercial insurance processes, ability to analyze outstanding account balances and follow up for resolution, experience processing claims, denials, and payment follow-up, strong documentation, organization, and communication skills are required.

Responsibilities

• Analyze and follow up on outstanding account balances while establishing acceptable payment arrangements.
• Support timely claim resolution, insurance follow-up, and denial management while maintaining compliance with organizational, regulatory, and safety standards.
• Process claims populating into the Ambulatory Claims Manager (ACM) system.
• Resolve invalid and rejected claims within established timeframes.
• Document account status and actions taken within system notes.
• Refer delinquent responses and new denials to management as appropriate.
• Process hard copy claims for payment.
• Obtain and attach Explanation of Benefits (EOBs) for secondary and tertiary billing.
• Review claims for timely filing guidelines and fee schedule reimbursement prior to submission.
• Maintain and respond to practice communications, including Requests for Additional Information (RAIs).
• Monitor and escalate lack of responses when necessary.
• Assist with special projects, including reviewing “unable to bill” claims and investigating denial reports.
• Maintain compliance with HIPAA regulations and patient confidentiality requirements.
• Follow all applicable patient and employee safety practices.
• Perform all other duties as assigned.

Qualifications

• High School Diploma or GED preferred.

Benefits

We offer a comprehensive benefits program for you and your family, professional development and support, various employee perks including 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.

Pay

N/A

Schedule

N/A

Skills

Strong understanding of commercial insurance processes, ability to analyze outstanding account balances and follow up for resolution, experience processing claims, denials, and payment follow-up, strong documentation, organization, and communication skills.

Benefits

We offer a comprehensive benefits program for you and your family, professional development and support, various employee perks including 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.

Company Info

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.

Apply Now

Ready to be part of a team that values your skills and dedication? Apply now and take the next step in your career with us.