PFS Billing Representative

1 month ago


Greenville, South Carolina, United States Prisma Health Full time
Job Summary
As a PFS Billing Representative at Prisma Health, you will play a critical role in ensuring accurate and timely submission of claims to various payer sources. Your attention to detail and ability to work independently will be essential in resolving Discharged Not Final Billed/Stop Bill errors and Claim Edits. You will also be responsible for processing daily paper claims submissions and following up on Specialty AR accounts to determine if claims have been accepted and processed for payment or denied.

Key Responsibilities
Process and resolve Discharged Not Final Billed/Stop Bill errors and Claim Edits
Submit claims to various payer sources in a timely manner
Follow up on Specialty AR accounts to determine if claims have been accepted and processed for payment or denied
Identify and resolve root causes of non-payment denials
Escalate accounts as necessary to keep AR aging at acceptable levels

Requirements
3 years of experience in hospital claims and billing follow-up
Knowledge of payer guidelines and hospital and physician claim forms
High School diploma or equivalent OR post-high school diploma/highest degree earned

Preferred Qualifications
CRCA or CRCR certification
Facility claims and billing follow-up and/or medical office experience
Strong communication skills and attention to detail

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