PFS Specialist I
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Job Description
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.
IMC is currently looking for a PFS Specialist I, who ensures that designated claims for all Commercial, Workman Comp, Medicaid Secondary or Medicare insurance claims are filed to the insurance company and collected on in a timely and accurate manner. Assists in helping to resolve any patient requests/issues, as requested. Ensures that any and all actions taken on account are thoroughly noted in the computer system. Completes Medicare Credit Balance report timely and correctly on a quarterly basis if applicable.
SCHEDULE
- Full-Time
JOB RELATIONSHIP
- WORKERS SUPERVISED: None
- SUPERVISED BY: PFS Assistant Manager
QUALIFICATIONS:
- Education: High school graduate or equivalent.
- Licensure/Certification: N/A.
- Training and Experience: 2-3 years previous hospital business office experience related to the filing and collection of insurance claims. Must have thorough knowledge of insurance reimbursement methods.
PRINCIPLE TASKS, DUTIES, AND RESPONSIBILITIES:
- Ensures that all designated Medicaid Secondary, Commercial, Workman Compensation or Medicare insurance claims are filed to the insurance company in a timely and accurate manner.
- Ensures that any denials, request for re-files, etc., that are received from the insurance company are followed-up on within 3-5 business days.
- Otherwise ensures that all monies due from insurance companies are received within acceptable timeframes, and in accordance with any contractual arrangements that may exist with payors.
- Assists in helping to resolve any patient requests/issues, as requested. Ensures that any and all actions taken on account are thoroughly noted in the computer system.
- Completes Medicare Credit Balance report timely and correctly on a quarterly basis if applicable.
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