PFS Government A​/R Specialist

Location Address:
Remote Office Santa Fe, NM 87501

Compensation Pay Range:
Minimum Offer $16.66 Maximum Offer $26.70

Now Hiring: PFS Government A/R Specialist I

Summary:

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.

Type of Opportunity:
Full time

Job Exempt:
No

Job is based:
Remote Workers New Mexico

Work Shift:

Days (United States of America)

• Accurately submit insurance claims for all payer types, including Government payers
• Research, analyze, and resolve payer edits, rejections, and denials
• Ensure compliance with CMS, state/federal regulations, and payer contracts
• Manage A/R follow-up, appeals, and customer service inquiries
• Utilize payer portals and patient accounting systems to resolve billing errors
• Review and process claims for both electronic and paper submissions
• Conduct root cause analysis and support continuous improvement in claims processing

This is an excellent opportunity for candidates with strong attention to detail, problem-solving skills, and knowledge of medical billing and reimbursement practices.

Full Time - Exempt:
No Job is based at Rev Hugh Cooper Admin Center

Work hours:

Days

• Benefits:
  We offer a wide range of benefits including medical, wellness program, vision, dental, paid time off, retirement and more for FT employees.
• 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.
• Wellness Presbyterian'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.

• 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.
• Demonstrated ability to communicate effectively via telephone and in writing and be computer literate.
• Must be passionate about contributing to an organization focused on continuously improving patient experiences and the health of our community.
• Experience working in patient accounting billing system or claims clearinghouse, such as Epic or 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.
• Must have a strong work ethic and demonstrated ability to work effectively in a team environment.
• Must be able to prioritize and manage a high-volume, workload.
• Must be able to work in a fast-paced environment and contend with continually changing payer regulations and requirements.
• 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 Coordination of benefits and the Medicare MSPQ.
• Must have proficient knowledge of various payer requirements, claim submission processes for major insurances carriers and intermediaries.
• Must have basic knowledge of the revenue cycle processes.
• Must have the ability to provide a high-speed DSL or cable modem for a home office. A minimum standard speed for optimal performance of 25x10…