Patient Finance Service Coordinator

BOULDER CITY HOSPITAL. • Boulder City, NV

5h • $29 - $40

About The Position

The PFS Coordinator is expected to independently manage and resolve issues related to Past Due Claims, Technical Denials, At-Risk Claims, Referrals and Authorization Issues, Accounts Receivable Follow-Up, Payer Correspondence and Appeals, and Revenue Recovery Opportunities. The PFS Coordinator is expected to demonstrate ownership of assigned accounts through timely follow-up, proactive problem-solving, appropriate escalation of issues, and adherence to departmental productivity and quality standards.

Requirements

• Demonstrated knowledge of medical terminology, insurance terminology, and revenue cycle operations.
• Proficient in claims billing, appeals, denials management, collections, and payer audits.
• Strong understanding of Claim Adjustment Reason Codes (CARC) and Remittance Advice Remark Codes (RARC), including the ability to evaluate, research, and resolve denial-related issues.
• Demonstrated critical thinking and analytical skills with the ability to identify barriers within the claims lifecycle and develop effective solutions to achieve claim resolution.
• Ability to independently investigate and resolve complex billing and reimbursement issues.
• Strong written and verbal communication skills, including the ability to effectively communicate with payers, providers, leadership, and internal stakeholders.
• Experience educating clinical providers on documentation requirements, CPT coding, ICD-10 coding, medical necessity requirements, and revenue cycle best practices.
• Experience reviewing clinical documentation and progress notes to ensure alignment with billing, coding, and reimbursement requirements.
• Demonstrated experience managing high-dollar accounts and complex claim resolution.
• Strong appeal-writing skills, including the ability to prepare persuasive and well-supported appeals to insurance carriers.
• Ability to work independently with minimal supervision while effectively prioritizing workload and meeting departmental expectations.

Nice To Haves

• Preferred experience with both inpatient and outpatient hospital billing and reimbursement processes.

Responsibilities

• Manage and resolve issues related to Past Due Claims
• Manage and resolve issues related to Technical Denials
• Manage and resolve issues related to At-Risk Claims
• Manage and resolve issues related to Referrals and Authorization Issues
• Manage and resolve issues related to Accounts Receivable Follow-Up
• Manage and resolve issues related to Payer Correspondence and Appeals
• Manage and resolve issues related to Revenue Recovery Opportunities
• Demonstrate ownership of assigned accounts through timely follow-up
• Demonstrate proactive problem-solving
• Demonstrate appropriate escalation of issues
• Adhere to departmental productivity and quality standards

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed