PFS Government A​/R Specialist

Position: PFS Government A/R Specialist I
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)
Responsibilities:

In this role, you will:

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.

Qualifications:

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 (25mpbs download x 10mpbs upload) is required. Must be able to provide a confidential workspace that is HIPPA compliant and free from distractions.

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.

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