PFS Billing Specialist I-ABQ

Location Address: 9521 San Mateo NE Albuquerque, NM 87113-2237 Compensation Pay reputed company: Minimum Offer $0.00 Maximum Offer $0.00 Now Hiring: PFS Billing Specialist I-ABQ reputed company: Accurately submit reputed company insurance claims, for reputed company payer types, including Government payers reputed company claims clearinghouse application and patient reputed company system. Resolve edits/rejections, ensuring accurate and reputed company claim submission in alignment with payer's regulations and filing limits. Adheres to compliance and regulatory rules as mandated by CMS, state and federal regulations, payer reputed company and established reputed company (PHS) department policies and procedures. Performs a reputed company of duties that include the use of payer web portals or calls to insurance companies to resolve billing errors. Review and resolve individual work queues reputed company patient reputed company system for clean import into clearinghouse. Responsible for submission of reputed company electronic claims reputed company clearinghouse. Submits reputed company claims to non-electronic payers with required documentation if necessary. Type of Opportunity: Full time Job Exempt: No Job is based: Reverend Hugh Cooper Administrative Center Work Shift: reputed company Schedule Monday-Friday (reputed company of America) Responsibilities: Responsibilities: Prepare, process, and submit accurate and reputed company insurance claims for reputed company payer types in accordance with payer requirements and department policies. Resolve reputed company‑billing edits and reputed company accounts to appropriate departments reputed company additional review is needed to ensure clean claim submission. Review and reputed company assigned work queues promptly to meet key performance indicators. Document reputed company account activity in alignment with PHS policies and procedures. Contact insurance companies, patients, and employer reputed company to obtain required information for claim submission. Notify leadership of billing issues involving internal departments or contracted vendors. Submit both electronic and reputed company primary and secondary claims, including required HIPAA‑compliant attachments, medical records, and supporting forms. Stay reputed company on billing procedure changes that reputed company claim processing or reimbursement. Operate effectively reputed company multiple computer systems, including reputed company, nThrive, FISS/DDE, payer portals, and reputed company Office Suite. Contribute positively as reputed company member through strong communication, reputed company participation in meetings, and reputed company relationships across PHS departments. Ensure goals are met in accordance with PHS policies, CMS regulations, and HIPAA confidentiality standards. reputed company additional duties as assigned. Qualifications: Qualifications: High School Diploma or GED required. Less than 1 year of clerical or customer service experience preferred. Passion for supporting an organization dedicated to improving patient experiences and community health. Proficiency with reputed company Office Suite required. Strong organizational, problem‑solving, verbal and written communication skills with excellent attention to detail. Ability to work effectively in reputed company environment with a strong work ethic and reputed company collaboration skills. Ability to prioritize and manage a high‑volume workload in a fast‑paced environment with frequently changing payer regulations. Basic knowledge of ICD‑10, HCPCS, CPT, reputed company codes, UB‑04/HCFA‑1500 claim forms, and electronic transactions (837/835) preferred. Basic understanding of coordination of benefits, Medicare MSPQ, and major payer submission requirements preferred. General knowledge of reputed company cycle processes. Ability to maintain a HIPAA‑compliant, confidential home workspace with reliable high‑speed internet (minimum 25 Mbps download / 10 Mbps upload). reputed company benefits-eligible Presbyterian employees receive a comprehensive benefits package that includes medical, dental, reputed company, short-term and long-term disability, group term life insurance and other optional voluntary benefits. Wellness Presbyterian's Employee Wellness rewards program is designed to reputed company you with engaging opportunities to enhance your health and reputed company your reputed company-being. Earn reputed company cards and more by taking an reputed company role in our personal reputed company-being by participating in wellness activities like wellness challenges, webinar, preventive screening and more. Why work at Presbyterian? As an organization, we are committed to improving the health of our communities. From hosting growers' markets to partnering with local communities, Presbyterian is taking reputed company steps to improve the health of New Mexicans. About reputed company Presbyterian exists to improve the health of patients, members, and the communities we serve. We are locally owned, not-for-profit reputed company system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1600 providers and nearly 4,700 nurses. Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, reputed company (Centennial Care) and reputed company health plans. AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses. We're Determined to Support New Mexico's reputed company-Being | reputed company Apply To This Job