PFS Collection Specialist

Confluent Health•UNAVAILABLE, Indiana

6d•Remote

About The Position

Responsible for collecting commercial, government, and patient balances by following the approved processes, policies, and procedures set by the revenue cycle department. This is a fully remote position. The role follows up on claims and denials, reviews accounts receivable and insurance payments, investigates discrepancies, and supports accurate reimbursement and account resolution. It also responds to patient and payor inquiries, communicates collection issues, helps patients develop payment plans, and participates in continuing education.

Requirements

High school diploma or GED.
Computer proficiency and experience with Windows-based technologies.
Ability to handle confidential and sensitive information discreetly and securely.
Excellent problem-solving skills, attention to detail, and ability to manage multiple tasks independently.
Ability to handle difficult situations with a positive attitude.
Good interpersonal, oral, and written communication skills.
Strong organizational and time-management skills.
Ability to meet deadlines in a timely manner.
Ability to work as part of a team with peers and organizational leadership.
Strong interpersonal skills, including the ability to respond calmly and make rational decisions in stressful situations.

Nice To Haves

Prior work experience in a medical office setting.

Responsibilities

Monitor outstanding account balances and determine the next step in the collection process.
Follow up on claims and claim denials to ensure maximum reimbursement for services provided.
Review accounts receivable activities and call on outstanding balances or claims.
Generate appropriate paperwork, including original and re-filed insurance claim forms and collection letters.
Review insurance payments and Explanations of Benefits (EOBs) to determine whether reimbursement is accurate.
Navigate portals to send claims for adjudication.
Investigate and appeal denied or underpaid claims.
Respond promptly and courteously to patient and payor inquiries by telephone or written request.
Track and resolve discrepancies.
Follow up on unpaid insurance claims after denial to obtain claim settlement.
Audit insurance and patient accounts to determine whether a refund is needed.
Provide clear communication and customer service on collection issues to external customers and internal business partners.
Help patients develop patient payment plans.
Identify patterns and trends that indicate a potential issue.
Adhere to policies and procedures while supporting high-quality service and customer care.
Perform other duties that may be necessary or in the organization's best interest.
Submit billing data to insurance providers.
Participate in continuing educational activities related to assigned duties and responsibilities.