PFS Quality Review Specialist

Found in: Resume Library US A2 - 2 weeks ago


Sarasota Florida, United States Sarasota Memorial Health Care System Full time
Job Summary:
The PFS Quality Review Specialist works with internal staff and third party payers to ensure timely recovery of outstanding Accounts Receivable by maintaining high productivity standards for outgoing collection calls. In addition to conducting reviews of other collectors accounts and collection activity/actions, reviewing notes, tracking activity, and ensuring proper actions are taken timely, the PFS Quality Review Specialist provides training and payer update information in private or public forums, as well as, ensuring collectors are familiar with tools and processes available to enhance efficiency and optimization of the collection process.

Required Qualifications:
- Require a minimum of six (6) years of experience in a healthcare business office. Bachelor's degree can substitute for four years of experience on a year-for-year basis.
- Require competence in three (3) or more functional areas including: Billing, Collections, Customer Service, Cash Posting, and/or Registration.
- Require Certified Patient Account Technician (CPAT) certificate or Certified Revenue Cycle Specialist (CRCS).

Preferred Qualifications:
- Prefer extensive experience in healthcare working with Third Party Billing and Collections with general knowledge of billing, collections, and finance.
- Prefer working knowledge of payer operations, claim processing, payment methodology and ability to train/teach other employees.
- Prefer demonstrated computer literacy with Windows-based software programs, as well as, the ability to review and update both patient and insurance information in the computer system.
- Prefer strong written and verbal communication skills with the ability to communicate effectively and with a distinct speaking voice.
- Prefer the ability to quickly resolve customer complaints.

Mandatory Education:
HS EQ: High School Diploma, GED or Certificate

Preferred Education:

Required License and Certs:

Preferred License and Certs:



  • Sarasota, United States Safe Children Coalition Inc Full time

    Job DescriptionJob DescriptionDescription:Are you interested in becoming an integral part of our Quality Assurance Team? Would you like to help support and improve the important work being done in child welfare in Desoto, Manatee, and Sarasota counties? The Safe Children Coalition Quality Assurance Department is an amazing supportive team that works closely...

  • Billing Operations Specialist

    Found in: Resume Library US A2 - 7 days ago


    Sarasota, Florida, United States Informa Global Support Full time

    Job Description The purpose of the Billing Specialist - Accounts Receivable role is to generate invoices;  review contracts & letter of agreements; determine revenue recognition & deferred revenue for the various companies supported by the shared service office.  You must ensure that all duties are carried out in line with company policies and within set...


  • Sarasota, United States Scanco Full time

    Job DescriptionJob DescriptionSalary: $60,000/yearJob Summary    The role of the Quality Assurance Specialist II is to execute manual test cases, perform functional confidence and regression testing prior to deployment to identify and report defects, analyze product requirements, identify and author test cases, and perform risk analysis to...


  • Sarasota, United States Scanco Full time

    Job DescriptionJob DescriptionSalary: $60,000/yearJob Summary    The role of the Quality Assurance Specialist II is to execute manual test cases, perform functional confidence and regression testing prior to deployment to identify and report defects, analyze product requirements, identify and author test cases, and perform risk analysis to...

  • Nursing Quality Spec II PRN

    Found in: Resume Library US A2 - 7 days ago


    Sarasota, Florida, United States Sarasota Memorial Health Care System Full time

    Job Summary: The Nursing Quality Specialist II (NQS II) is responsible for providing support to the nursing division for performance improvement activities to enhance quality and safety outcomes, as well as, regulatory oversight, compliance monitoring with standards of care, and facilitating positive inter-professional collaboration with various disciplines....

  • Legal Support Specialist

    Found in: Resume Library US A2 - 2 weeks ago


    Sarasota, Florida, United States Williams Parker Full time

    Williams Parker, the region's largest and oldest law firm, is actively seeking Legal Support Specialists to join our client-centric team. A Legal Support Specialist facilitates the efficient operation of assigned department(s) by performing a variety of clerical and administrative tasks. This is a generalist role that includes providing coverage for legal...

  • Utilization Review Specialist

    Found in: Resume Library US A2 - 1 day ago


    Wesley Chapel, Florida, United States North Tampa Behavioral Health Full time

    Overview: Shift: 7am - 3:30pm   PURPOSE STATEMENT: Proactively monitor utilization of services for patients to optimize reimbursement for the facility. Responsibilities: ESSENTIAL FUNCTIONS: Act as liaison between managed care organizations and the facility professional clinical staff. Conduct reviews, in accordance with certification requirements, of...

  • Remote SEO Specialist

    Found in: Resume Library US A2 - 2 weeks ago


    Sarasota, Florida, United States Dental Care Alliance Full time

    Overview: The SEO Specialist will work closely with the Digital Marketing Director and agency partners to monitor and improve SEO performance across the organization. A key goal of the SEO Specialist will be increasing patients generated through organic search sources. This person will serve as the team expert for anything Search Engine Optimization...


  • Sarasota, United States Boar's Head BrandFrank Brunckhorst Co., LLC Full time

    Hiring Company: Delicatessen Services Co., LLC Overview:The Regulatory Compliance Specialist is responsible for maintaining and managing regulatory compliance documentation using the corporate Quality Management System. This individual serves as the primary technical resource for ensuring vendor compliance with regulatory documentation requirements, as well...

  • Reimbursement Specialist II

    Found in: Resume Library US A2 - 4 hours ago


    Sarasota, Florida, United States Sarasota Memorial Health Care System Full time

    Job Summary: Provides administrative support responsible for accurate and timely posting of Surgery, Emergency Room (ECC) charges for either SMHCS or North Port, hospital wide observation charges, or Delivery/High Risk Antepartum/Testing/Triage charges, under the direction and supervision of Revenue Cycle Management. Provides compliant charging practices...


  • Sarasota, United States Boar's Head BrandFrank Brunckhorst Co., LLC Full time

    Hiring Company: Delicatessen Services Co., LLC Overview:The Regulatory Compliance Specialist is responsible for maintaining and managing regulatory compliance documentation using the corporate Quality Management System. This individual serves as the primary technical resource for ensuring vendor compliance with regulatory documentation requirements, as well...


  • Sarasota, United States CareerBuilder Full time

    Hiring Company: Delicatessen Services Co., LLC Overview:The Regulatory Compliance Specialist is responsible for maintaining and managing regulatory compliance documentation using the corporate Quality Management System. This individual serves as the primary technical resource for ensuring vendor compliance with regulatory documentation requirements, as well...

  • Quality Control Underwriting Specialist

    Found in: Resume Library US A2 - 2 weeks ago


    Orlando, Florida, United States Gallagher Full time

    About Us: Discover a world of endless possibilities at Gallagher Benefit Services, where you'll have the power to shape the future of workplaces across industries. As a member of our team, you become the driving force behind positive change, helping clients build environments where employees thrive. Embrace the opportunity to impact lives, unlock potential,...

  • eLearning Specialist

    Found in: beBee jobs US - 7 days ago


    Sarasota, Florida, United States Boar's Head Brand Full time

    Hiring Company:Delicatessen Services Co., LLCOverview:Under the direction of the Director of Customer Experience, the candidate will serve as eLearning specialist for the Training Design and Development team. The eLearning Specialist is responsible for the design, development, deployment and maintenance of a catalogue of training materials designed to...

  • Clinical Document Integrity Lead

    Found in: Resume Library US A2 - 5 days ago


    Sarasota, Florida, United States Travel Hire Full time

    Job Description Department Revenue Cycle Job Summary The Clinical Documentation Integrity Lead is responsible for assisting and supporting leadership in planning, directing, and controlling all aspects of the day-to-day operations for the Clinical Documentation Integrity (CDI) program by establishing a collaborative rapport with CDI Specialists,...


  • Sarasota, United States Williams Parker Full time

    Job DescriptionJob DescriptionWilliams Parker, the region's largest and oldest law firm, is actively seeking Legal Support Specialists to join our client-centric team. A Legal Support Specialist facilitates the efficient operation of assigned department(s) by performing a variety of clerical and administrative tasks. This is a generalist role that...

  • Legal Support Specialist

    Found in: Talent US C2 - 7 days ago


    Sarasota, United States Williams Parker Full time

    Williams Parker, the region's largest and oldest law firm, is actively seeking Legal Support Specialists to join our client-centric team. A Legal Support Specialist facilitates the efficient operation of assigned department(s) by performing a variety of clerical and administrative tasks. This is a generalist role that includes providing coverage for legal...


  • Sarasota, United States Invisible Ventures Full time

    Job DescriptionJob DescriptionSalary: Want to work with clients and their nationally recognized brands? ATLARGE is adding to our team of explorers and change-makers. We’re hiring a full-time communications specialist. Leading organizations partner with ATLARGE to drive their customer acquisition and recognition. We accomplish this by:developing...


  • Sarasota, United States Invisible Ventures Full time

    Job DescriptionJob DescriptionSalary: Want to work with clients and their nationally recognized brands? ATLARGE is adding to our team of explorers and change-makers. We’re hiring a full-time communications specialist. Leading organizations partner with ATLARGE to drive their customer acquisition and recognition. We accomplish this by:developing...

  • Research Nurse/Grant Specialist

    Found in: Resume Library US A2 - 7 days ago


    Sarasota, Florida, United States Sarasota Memorial Health Care System Full time

    Job Summary: Responsible for writing and applying for research specific grants to support unfunded or under-funded initiatives of the Research Institute. Collaborates with clinicians, researchers, grant agencies, regulatory bodies, finance, business, legal and other services to ensure timely and accurate grant applications and tracking. Assists with...