PFS Insurance Specialist I

Compensation:

$27.00 - 28.00 per hour

Job Overview:

The PFS Insurance Specialist's main role is to assist the collections team towards department goals of increasing cash collections and improving reimbursement rates. The PFS Specialist should have the ability to work on any claim, regardless of aging, and must work with both commercial and government payers, and review EOB's.

Job Responsibilities:

• Works with collections team to ensure daily productivity and quality standards are met, as well as assist with training and coaching to ensure all team members are operating at full potential
• Creates notes on the patients account for auditing and actions taken per the Standard Operating Procedures or as outlined by the team manager
• Works the total patient accounts outstanding A/R including credits and denials to reduce A/R aging buckets per the department's goals
• Works hand in hand with the other team members to correct errors
• Send corrected claims and appeals based on payer guidelines in a timely manner
• Other projects as assigned

Education and Knowledge:

• High school diploma plus some college preferred
• Knowledge of CPT codes, medical terminology, insurance plans, ICD 10 codes
• Must have ability to adapt to a fast paced, dynamic environment
• Must understand different payer plans collections process, Xifin knowledge preferred

Technical Competencies:

• Must have excellent computer skills
• Must understand the different payer plans and basic understanding of A/R
• Must have working knowledge of MS Excel

Experience:

• 1-2 years' experience in a clinical laboratory preferred, especially genetic billing
• 1-2 years' experience in working denials

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