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PFS Representative I (1209)

Billing Specialist | Dallas, TX | Contract

Job Description

PFS Representative I
Work Location: Dallas, TX

Job Duties/Responsibilities/Functions(including but not limited to)

• Ensure all claims are billed and received by the payers for proper adjudication. This includes timely processing of allocated volume of accounts, based on established production guidelines and time parameters provided for workflow.

• Responsible for outbound calls and/or status inquiries via payer’s website validating receipt of medical claims and adjudication status within established timeframes. Display competent ability to access, navigate, and manage account information through phone calls and payer websites.

• Work any edits and denials in allocated workflow to achieve proper adjudication to payment. This includes but is not limited to: verify insurance is correct, update insurance demographics, rebill claims not received, document the status of work performed, follow-up on outstanding adjudication items according to departmental guidelines, and is also responsible for billing secondary/tertiary claims along with providing supporting documentation to payers for additional payment.

• Documents all work and calls performed, in accordance to policy. This includes complete contact information, good grammar, and expected outcomes.

• Obtain primary and/or secondary EOB and claims to bill next responsible payer, along with utilizing various internal resources to obtain medical records to respond to requests from payers upon request.

• Performs other duties as assigned.

Minimum Qualifications

• High School Diploma or equivalent. Bachelors preferred.

• Minimum 2 years hospital or medical billing experience.

• Knowledge of health insurance mechanisms and coverage is required.

• Effective oral and written communications skills.

• Proficient keyboarding, accuracy and math aptitude skills.

About InGenesis

InGenesis is dedicated to placing people in positions that preserve life, improve lives and inspire others. This does not happen without passionate people, skilled colleagues who are motivated to create innovative solutions and deliver superior service to our clients. Founded in 1998, InGenesis manages thousands of employees, including pioneering healthcare, science, technology and pharma professionals. The workforce solutions company includes almost half of the Fortune 500 in its nearly 300 clients. It is recognized as one of the largest healthcare staffing firms, and InGenesis is the largest minority/women owned healthcare staffing firm in North America.

EEOC Statement

We support a diverse workforce and is an Equal Opportunity Employer who does not discriminate against employees and applicants for employment on the basis of race, gender, color, religion, national origin, age, sexual orientation, gender identity, genetic information, disability, veteran status, or other classification protected by law.