PFS Specialist II- Patient Financial Services

## Description ### *(Helping Patients and Practices Navigate the Financial Side of Care)* ## **What We’re Looking For:** - A detail-oriented professional with experience in **Business Office operations and Insurance Collections** - Strong understanding of **commercial insurance processes** - Ability to analyze outstanding account balances and follow up for resolution - Experience processing claims, denials, and payment follow-up - Strong documentation, organization, and communication skills - High School Diploma or GED **preferred** * * * ## **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: https://www.brgeneral.org/about/careers/perks * * * ## **What You Will Do:** Analyze and follow up on outstanding account balances while establishing acceptable payment arrangements. This role supports timely claim resolution, insurance follow-up, and denial management while maintaining compliance with organizational, regulatory, and safety standards. **Essential job functions include, but are not limited to:** - Process claims populating into the Ambulatory Claims Manager (ACM) system - Resolve invalid and rejected claims within established timeframes - Document account status and actions taken within system notes - Refer delinquent responses and new denials to management as appropriate - Process hard copy claims for payment - Obtain and attach Explanation of Benefits (EOBs) for secondary and tertiary billing - Review claims for timely filing guidelines and fee schedule reimbursement prior to submission - Maintain and respond to practice communications, including Requests for Additional Information (RAIs) - Monitor and escalate lack of responses when necessary - Assist with special projects, including reviewing “unable to bill” claims and investigating denial reports - Maintain compliance with HIPAA regulations and patient confidentiality requirements - Follow all applicable patient and employee safety practices - Perform all 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.*