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PFS Representative, CBO, Ambulatory Billing Follow-up, Medicare
Banner Health. Follow up with assigned payers regarding denials, including authorization and eligibility denials .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in Medical Insurance Accounts Receivable, including processing denials, appeals, and payment reconciliations. Proficient in Microsoft Excel and skilled in managing patient billing and collections while maintaining strong communication with internal and external stakeholders.
Highest-signal resume keywords
Medical Insurance Accounts ReceivableAppeal Letter WritingMicrosoft ExcelPatient Financial Services KnowledgeCash Collections Experience
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Payment ProcessingClaims ManagementDenial ResolutionAccount ReconciliationFinancial Analysis
Soft Skills
Interpersonal CommunicationOral CommunicationWritten CommunicationTask ManagementIndependent Work
Tools & Technologies
Office SoftwareWord Processing SoftwareSpreadsheet SoftwareDatabase Software
Industry Keywords
Payer DenialsFinancial Class IssuesCharity ApplicationsBilling ActivitiesInsurance Industry Processes
About the role
Key responsibilities & impact- Follow up with assigned payers regarding denials, including authorization and eligibility denials
- Coordinate and facilitate patient billing and collection activities
- Process payments, adjustments, claims, correspondence, refunds, denials, financial/charity applications, and payment plans as assigned
- Reconcile, balance, and pursue account balances, payments, and denials
- Research payments, denials, and accounts to identify short/overpayments, contract discrepancies, financial class issues, and errors
- Make appeals and corrections as necessary
- Build working relationships with business units, hospital departments, and provider offices
- Identify payment issue trends and communicate with internal and external customers
- Respond to incoming calls and make outbound calls to resolve billing, payment, and accounting issues
- Work with the patient financial services team to reduce accounts receivable balances and achieve outstanding-account goals
- Document information in systems, provide statistical data, prepare issue lists, and communicate accurately with payers
- Work independently under general supervision and report to a Supervisor or Manager
Requirements
What you’ll need- Minimum of 1 year experience in Medical Insurance AR (Medicare experience preferred) and/or Physician Fee for Service Billing
- Minimum of 1 year experience writing appeal letters for payer denials
- Intermediate to Advanced skill level in Microsoft Excel
- Residence in one of the permitted states: AL, AK, AR, AZ, CA, CO, FL, GA, IA, ID, IN, KS, KY, LA, MD, MI, MN, MO, MS, NC, ND, NE, NH, NY, NM, NV, OH, OK, OR, PA, SC, TN, TX, UT, VA, WA, WI, WV, WY
- High school diploma/GED or equivalent working knowledge
- Knowledge of patient financial services, financial/collecting services, or insurance industry processes
- Ability to manage multiple tasks simultaneously with minimal supervision and work independently
- Strong interpersonal, oral, and written communication skills
- Strong knowledge of common office software, word processing, spreadsheet, and database software
- Work experience with the company's systems and processes preferred
- Previous cash collections experience preferred
- Additional related education and/or experience preferred
Benefits
Comp & perks- Great Place To Work® Certification™ workplace investment
- Stimulating and rewarding careers
- EEO/Disabled/Veterans workplace commitment
- Drug-free work environment