PFS Insurance Follow-Up Rep Ambulatory Denials
Richmond, Henrico County, Virginia, 23298, USA
Listed on 2026-06-26
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Healthcare
Healthcare Administration, Medical Billing and Coding
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Estimated Pay Range:
$17.58 - $26.36 / hour, based on location, education, & experience.
Department Name:
Work
Shift:
Day
Job Category:
Revenue Cycle
Estimated Pay Range:
$17.58 - $26.36 / hour, based on location, education, & experience.
In accordance with State Pay Transparency Rules.
Innovation and highly trained staff. Banner Health recently earned Great Place To Work Certification. This recognition reflects our investment in workplace excellence and the happiness, satisfaction, wellbeing and fulfilment of our team members. Find out how we’re constantly improving to make Banner Health the best place to work and receive care.
The PFS Insurance Follow-Up Representative (Ambulatory Denials) is responsible for following up with assigned payer for various denials, such as no authorization, eligibility denials, etc. This position is a higher-level PFS role, as it does range across all groups of patients and all types of provider specialties. Experience with in medical insurance accounts receivable (AR) and physician fee-for-service billing is ideal.
Location:
Remote
Schedule: Monday-Friday, varying shifts 6am-6pm after successful completion of training program.
Ideal Candidate:
- Minimum of 1 year experience in Medical Insurance AR and/or Physician Fee for Service Billing clearly reflected in uploaded resume;
- Minimum of 1 year experience writing appeal letters for payer/payor denials;
- Intermediate to Advanced skill level in Microsoft Excel.
Position Summary
This position coordinates and facilitates patient billing and collection activities in one or more assigned areas of billing, payment posting, collections, payor claims research, and other accounts receivable work. Works as a member of a team to ensure reimbursement for services in a timely and accurate manner.
Core Functions
- May be assigned to process payments, adjustments, claims, correspondence, refunds, denials, financial/charity applications, and/or payment plans in an accurate and timely manner, meeting goals in work quality and productivity. Coordinates with other staff members and physician office staff as necessary ensure correct processing.
- As assigned, reconciles, balances and pursues account balances and payments, and/or denials, working with payor remits, facility contracts, payor customer service, provider representatives, spreadsheets and the company’s collection/self-pay policies to ensure maximum reimbursement.
- May be assigned to research payments, denials and/or accounts to determine short/over payments, contract discrepancies, incorrect financial classes, internal/external errors. Makes appeals and corrections as necessary.
- Builds strong working relationships with assigned business units, hospital departments or provider offices. Identifies trends in payment issues and communicates with internal and external customers as appropriate to educate and correct problems. Provides assistance and excellent customer service to these internal clients.
- Responds to incoming calls and makes outbound calls as required to resolve billing, payment and accounting issues. Provides assistance and excellent customer service to patients, patient families, providers, and other internal and external customers.
- Works as a member of the patient financial services team to achieve goals in days and dollars of outstanding accounts. Reduces Accounts Receivable balances.
- Uses systems to document and to provide statistical data, prepare issues list(s) and to communicate with payors accurately.
- Works independently under general supervision, following defined standards and procedures. Reports…
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