PFS Government A / R Specialist I-ABQ

Pfs Government A / R Specialist

Presbyterian healthcare is hiring a PFS Government A / R Specialist to accurately submit all insurance claims, for all payer types, including Government payers within claims clearinghouse application and patient accounting system. Research, analyze and follow-up on all payer edits / rejections, ensuring accurate and timely claim submission in alignment with payer's regulations and filing limits. Adheres to compliance and regulatory rules as mandated by CMS, state and federal regulations, payer contracts and established Presbyterian Healthcare Services (PHS) department policies and procedures. Performs a variety of duties that include the use of payer web portals or calls to insurance companies to resolve billing errors. Review and resolve individual work queues within patient accounting system for clean import into clearinghouse. Responsible for submission of all electronic claims within clearinghouse. Submits paper claims to non-electronic payers with required documentation if necessary. Responsible for root cause analysis and next step resolution of denials. Performs a variety of duties, including A / R follow-up, appeals, customer service, processing of correspondence, and daily reconciliation of activities.

We're determined to take care of those working in healthcare.

Presbyterian is dedicated to improving people's lives - the lives of our patients and the lives of our coworkers. We're locally owned and operated, which encourages supportive leadership that empowers employees. And we provide the opportunity to grow from entry-level to the most senior positions.

Why Join Us

• Full Time - Exempt : No
• Job is based at Rev Hugh Cooper Admin Center
• Work hours : Days
• Benefits : We offer a wide range of benefits including medical, wellness program, vision, dental, paid time off, retirement and more for FT employees.

Qualifications

Responsibilities

Benefits

All benefits-eligible Presbyterian employees receive a comprehensive benefits package that includes medical, dental, vision, short-term and long-term disability, group term life insurance and other optional voluntary benefits.

Wellness Presbyterian's Employee Wellness rewards program is designed to provide you with engaging opportunities to enhance your health and activate your well-being. Earn gift cards and more by taking an active role in our personal well-being by participating in wellness activities like wellness challenges, webinar, preventive screening and more.

Why work at Presbyterian? As an organization, we are committed to improving the health of our communities. From hosting growers' markets to partnering with local communities, Presbyterian is taking active steps to improve the health of New Mexicans.

About Presbyterian Healthcare Services Presbyterian exists to ensure the patients, members and communities we serve can achieve their best health. We are a locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees.

Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.

AA / EOE / VET / DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.

Maximum Offer for this position is up to

USD $23.04 / Hr.

Compensation Disclaimer

The compensation range for this role takes into account a wide range of factors, including but not limited to experience and training, internal equity, and other business and organizational needs.