PFS Biller Specialist
2 months ago
We are seeking a skilled PFS Biller to join our team at Prisma Health. As a key member of our Patient Account Services department, you will play a critical role in ensuring accurate and timely submission of claims to various payer sources.
Key Responsibilities- Process and follow up on specialty AR accounts to determine if claims have been accepted and processed for payment or denied.
- Review claim rejections and re-bill accounts when necessary, effectively identifying the root cause of non-payment denials and working with insurance companies, patients, and Prisma Health departments to find resolution.
- Escalate accounts both at the payer and internally when appropriate, involving patients as needed to keep AR aging at acceptable levels.
- Identify system issues through trending and repetitive actions, recommending workflow reviews or changes to resolve compliant billing.
- Communicate with Prisma Health department teams on specific errors for corrections related to their area of responsibility.
- Follow up with insurance payers, patients, or guarantors at established intervals to determine the reason for delay and expedite payment.
- High school diploma or equivalent.
- 3 years of hospital claims and billing follow-up experience, with knowledge of payer guidelines.
- Facility claims and billing follow-up and/or medical office experience required.
- Communication skills and respect for details preferred.
- CRCA or CRCR certification preferred.
Our vision is simple: to transform healthcare for the benefit of the communities we serve. We are committed to excellence, quality, and patient-centered care. If you share our vision and values, we encourage you to apply for this exciting opportunity to join our team at Prisma Health.
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