PFS Specialist II

## Description **Are you passionate about ensuring financial accuracy and supporting patient care through effective account resolution?** * * * **What We’re Looking For:** - - Detail-oriented with strong organizational and investigative skills - Self-motivated and proactive with a customer-first mindset - Prior experience in all phases of business office operations and insurance collections - High School Diploma or GED preferred - Excellent understanding and knowledge of Commercial Insurance - Familiarity with HIPAA regulations related to medical records and financial data - Knowledge of safety practices relevant to billing and administrative roles * * * **Why You'll Love Working With Us:** At Baton Rouge General our patients aren't the only people we take care of; we take care of our team too. We are proud to offer our employees the benefits and resources they need to be their best selves at work and at home. - - A comprehensive benefits program for you and your family - Professional development and support - Various employee perks include generous paid time off, flexible positions, and our Baton Rouge General Fit! program - We are a nationally and locally recognized leader in quality and ranked one of the best healthcare employers in the state Check out our employee perks [Perks | Baton Rouge General](https://www.brgeneral.org/about/careers/perks) * * * **What You Will Do:** Analyze and follow up on outstanding account balances and establish acceptable payment arrangements to ensure timely and accurate reimbursement. - - Process claims populating into Ambulatory Claims Manager (ACM), resolving invalid/rejected claims within 5 days, documenting status, and referring issues to management. - Process hard copy claims for payment - Attach EOBs for secondary/tertiary claims - Ensure compliance with timely filing guidelines and fee schedule review - Maintain practice responses to communications - Create and respond to spreadsheets - Monitor for missing responses and escalate as needed - Resolve “unable to bill” claims by verifying insurance information - Investigate reports and monitor denial trends provided by management - Perform other duties as assigned * * * **What Sets BRG Apart:** At Baton Rouge General, we are a community of compassionate, caring individuals who set the bar when it comes to healthcare excellence. Our mission is to preserve and restore health, one person at a time. From clinical to non-clinical – what you do here matters. With over 600 licensed beds between three campuses, Baton Rouge General offers the full spectrum of care from delivering newborns to providing end of life support through hospice. With clinics located throughout Baton Rouge and the surrounding areas, our physician group provides patients with comprehensive care and a full suite of specialties, including internal and family medicine and specialty care. Ready to be part of a team that values your skills and dedication? Apply now and take the next step in your career with us.