PFS GOVERNMENT A/R SPECIALIST I

<p style="text-align:left"><b>Location Address:</b></p>Remote Office&amp;#xa;Santa Fe, NM 87501&amp;#xa;<p style="text-align:inherit"></p><p style="text-align:left"><b>Compensation Pay Range:</b></p>Minimum Offer $16.66&amp;#xa;Maximum Offer $26.70&amp;#xa;Now Hiring: PFS Government A/R Specialist I<p style="text-align:inherit"></p><p style="text-align:left"><b>Summary:</b></p><p style="text-align:inherit"></p>Build your Career. Make a Difference. Presbyterian is hiring a skilled PFS Government A/R Specialist I. This is an excellent opportunity for candidates with strong attention to detail, problem-solving skills, and knowledge of medical billing and reimbursement practices.&amp;#xa;&amp;#xa;Type of Opportunity: Full time&amp;#xa;Job Exempt: No&amp;#xa;Job is based: Remote Workers New Mexico&amp;#xa;Work Shift: Days (United States of America)&amp;#xa;<p></p><p><b>Responsibilities:</b></p><p></p><p>In this role, you will:</p><ul><li><p>Accurately submit <b>insurance claims</b> for all payer types, including Government payers</p></li><li><p>Research, analyze, and resolve <b>payer edits, rejections, and denials</b></p></li><li><p>Ensure compliance with <b>CMS, state/federal regulations, and payer contracts</b></p></li><li><p>Manage <b>A/R follow-up, appeals, and customer service inquiries</b></p></li><li><p>Utilize payer portals and patient accounting systems to resolve billing errors</p></li><li><p>Review and process claims for both <b>electronic and paper submissions</b></p></li><li><p>Conduct root cause analysis and support continuous improvement in claims processing</p></li></ul><p>This is an excellent opportunity for candidates with strong <b>attention to detail, problem-solving skills, and knowledge of medical billing and reimbursement practices</b>.</p><ul><li><p>Full Time - Exempt: No</p></li><li><p>Job is based at Rev Hugh Cooper Admin Center</p></li><li><p>Work hours: Days</p></li><li><p>Benefits: We offer a wide range of benefits including medical, wellness program, vision, dental, paid time off, retirement and more for FT employees.</p></li></ul><p></p><p><b>Qualifications:</b></p><p></p><ul><li><p>High school degree or GED required, short-term training on insurance collections and claims processing. Minimum one years experience in insurance follow-up, billing, and collections.</p></li><li><p>Demonstrated ability to communicate effectively via telephone and in writing and be computer literate.</p></li><li><p>Must be passionate about contributing to an organization focused on continuously improving patient experiences and the health of our community.</p></li><li><p>Experience working in patient accounting billing system or claims clearinghouse, such as Epic or</p></li><li><p>Thrive are preferred. Proficient with Microsoft Office Suite products required. Excellent organizational, problem-solving, verbal and written communication skills, along with, attention to detail and the ability to interact effectively with other functional areas and management teams are required.</p></li><li><p>Must have a strong work ethic and demonstrated ability to work effectively in a team environment.</p></li><li><p>Must be able to prioritize and manage a high-volume, workload.</p></li><li><p>Must be able to work in a fast-paced environment and contend with continually changing payer regulations and requirements.</p></li><li><p>Proficient knowledge of ICD-10, HCPCS, CPT codes, Revenue Codes, UB04 and HCFA 1500 claim forms and an understanding of electronic processing of 837 and 835. Proficient knowledge of</p></li><li><p>Coordination of benefits and the Medicare MSPQ. Must have proficient knowledge of various payer requirements, claim submission processes for major insurances carriers and intermediaries.</p></li><li><p>Must have basic knowledge of the revenue cycle processes.</p></li><li><p>Must have the ability to provide a high-speed DSL or cable modem for a home office.</p></li><li><p>A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required. Must be able to provide a confidential workspace that is HIPPA compliant and free from distractions.</p></li></ul><p></p><p>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.</p><p><br /><b>Wellness</b><br />Presbyterian&#39;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.</p><p><br /><b>Why work at Presbyterian?</b><br />As an organization, we are committed to improving the health of our communities. From hosting growers&#39; markets to partnering with local communities, Presbyterian is taking active steps to improve the health of New Mexicans.</p><p><br /><b>About Presbyterian Healthcare Services</b><br />Presbyterian exists to improve the health of patients, members, and the communities we serve. We are 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&#39;s largest private employer with nearly 14,000 employees - including more than 1600 providers and nearly 4,700 nurses.</p><p></p><p>Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.</p><p></p><p><i>AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.</i></p><p></p><h1><b>We&#39;re Determined to Support New Mexico&#39;s Well-Being | Presbyterian Healthcare Services</b></h1><p></p><p></p><p></p>