PFS Representative CBO Billing Follow-up Denials Mgt

PFS Representative CBO Billing Follow-up Denials Mgt role at Banner Health

Estimated Pay Range
: $18.02 - $27.03 / hour, based on location, education, & experience.

Department
:
Amb Billing & Follow Up

Work Shift
:
Day

Job Category
:
Revenue Cycle

Innovation and highly trained staff. Banner Health recently earned Great Place To Work® Certification™ and continues to improve workplace excellence.

Our PFS Representatives are crucial to the revenue cycle, reducing AR and improving patient experience post‑care. As a member of the PFS Rep CBO, Billing Follow‑up Denials Mgt team, you will work with insurance companies on behalf of patients to obtain payments for our acute and ambulatory teams. You’ll research and hold payers accountable to pay expected rates according to contracts, within allowed time frames.

Experience with different payers and various denial types (e.g., no authorization, eligibility denials) is a plus.

Schedule
:
Full time, Monday‑Friday, 8‑hour shifts, typically 8 am‑5 pm (depending on team)

Location
: REMOTE (Banner provides equipment). Remote position available only in the following states: AL, AK, AR, AZ, CA, CO, FL, GA, IA, , 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.

Ideal candidate
:

• 1 year patient financial services (Central Billing) or medical claims experience.
• Experience submitting appeals and understanding EOBs.
• General knowledge of codes used for claim processing.

This position coordinates and facilitates patient billing and collection activities in assigned areas of billing, payment posting, collections, payor claims research, and other accounts receivable work. Works as a team member to ensure reimbursement for services in a timely and accurate manner.

• Process payments, adjustments, claims, correspondence, refunds, denials, financial/charity applications, and payment plans accurately and timely.
• Reconcile, balance, and pursue account balances and payments or denials, working with payor remits, facility contracts, payor customer service, provider representatives, spreadsheets, and company collection/self‑pay policies to maximize reimbursement.
• Research payments, denials, and accounts to identify short/over‑payments, contract discrepancies, incorrect financial classes, internal/external errors, and make appeals and corrections as necessary.
• Build strong relationships with business units, hospital departments, or provider offices; identify payment issue trends and communicate with internal and external customers to educate and correct problems.
• Handle incoming calls and make outbound calls to resolve billing, payment, and accounting issues, providing excellent customer service to patients, families, providers, and other customers.
• Work independently under general supervision, following defined standards and procedures, to meet goals in days and dollars of outstanding accounts.
• Use systems to document, provide statistical data, prepare issue lists, and communicate with payors accurately.

High school diploma/GED or equivalent. Knowledge of patient financial services, financial/collecting services, or insurance industry processes normally acquired over one or more years of work experience.

Ability to manage multiple tasks simultaneously with minimal supervision, work independently, and possess strong interpersonal, oral, and written communication skills.

Strong knowledge of common office software (word processing, spreadsheets, database software) required.

• Experience with the Company’s systems and processes.
• Previous cash collections experience.

Any relevant education or experience not listed above.

Anticipated Closing Window
:

EEO/Disabled/Veterans. Our organization supports a drug‑free work environment.