Baton Rouge General Medical Center · 1 day ago
PFS Specialist II (Claims)- Patient Financial Services
Baton Rouge, LA
Full-time
Onsite
Mid LevelBaton Rouge General Medical Center is a community-focused healthcare provider known for its commitment to quality care. They are seeking a PFS Specialist II to ensure financial accuracy by analyzing and resolving outstanding account balances, processing claims, and maintaining compliance with insurance guidelines.
Hospital & Health Care
Responsibilities
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
Qualification
Required
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
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
Preferred
High School Diploma or GED preferred
Benefits
A comprehensive benefits program for you and your family
Professional development and support
Various employee perks include generous paid time off
Flexible positions
Our Baton Rouge General Fit! program
Company
Baton Rouge General Medical Center
Baton Rouge General Medical Center is a community hospital.
1001-5000 employees
Funding
Current Stage
Late StageLeadership Team
Angie Clouatre
Chief Nursing Officer - Mid City Campus
Monica Nijoka
CNO
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