Patient Financial Services Billing Specialist

🔥 13 hours ago

🌶️ New Mexico – Remote

🌶️ New Mexico – Remote

💵 $16 - $26 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

📊 Billing Specialist

🦅 H1B Visa Sponsor

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Presbyterian Healthcare Services

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1908

🏥 Healthcare

⚕️ Healthcare Insurance

🤝 Non-profit

Healthcare • Healthcare Insurance • Non-profit

Presbyterian Healthcare Services is an integrated, nonprofit healthcare system based in New Mexico that operates hospitals, urgent care clinics, specialty and primary care practices, virtual care (VirtualPRES), and health insurance plans. The organization provides a broad range of clinical services—including neuroscience, transplant, cancer care, surgery, behavioral health, and home health—while also running community health and charitable programs (financial assistance, community support, and partnerships with medical education). It offers individual, Medicaid, Medicare Advantage, and employer health plans, plus patient tools (MyChart/myPRES), billing support, and commitment to access and quality across the state.

📋 Description

• Accurately submit insurance claims for all payer types, including government payers, through the claims clearinghouse and patient accounting system. • Resolve claim edits and rejections in alignment with payer regulations and filing limits. • Adhere to CMS, state and federal regulations, payer contracts, and Presbyterian Healthcare Services policies and procedures. • Use payer web portals and contact insurance companies to resolve billing errors. • Review and resolve individual work queues for clean import into the clearinghouse and to meet performance indicators. • Submit electronic claims through the clearinghouse. • Submit paper claims to non-electronic payers with required documentation. • Prepare, process, and file accurate and timely primary and secondary insurance claims. • Refer accounts with claim edits to appropriate departments for additional review. • Document accounts according to established policies and procedures. • Contact insurance companies, patients, and employer groups to obtain claim-submission information. • Notify leadership of billing issues involving internal departments or contracted vendors. • Submit HIPAA-compliant attachments, medical records, correspondence, and payer forms. • Stay informed about billing procedure changes affecting claim processing and reimbursement. • Operate Epic, nThrive, FISS/DDE, Presbyterian Health Plan Provider Portal, payer portals, and Microsoft Office Suite. • Participate in team meetings and communicate work-related ideas and concerns. • Maintain positive working relationships with team members and PHS departments. • Ensure goals and objectives comply with PHS policies and CMS rules. • Maintain confidentiality and follow HIPAA guidelines and regulations. • Perform other duties as assigned.

🎯 Requirements

• High School Diploma or GED required. • Less than 1-year clerical or customer service experience preferred. • Experience with Microsoft Office Suite products required. • Excellent organizational, problem-solving, verbal and written communication skills. • Attention to detail and ability to interact effectively with other functional areas and management teams. • Strong work ethic and ability to work effectively in a team environment. • Ability to prioritize and manage a high-volume workload. • Ability to work in a fast-paced environment and contend with changing payer regulations and requirements. • Basic knowledge of ICD-10, HCPCS, CPT codes, Revenue Codes, UB04 and HCFA 1500 claim forms preferred. • Understanding of electronic processing of 837 and 835 preferred. • Basic knowledge of coordination of benefits and Medicare MSPQ preferred. • Basic knowledge of payer requirements and claim submission processes for major insurance carriers and intermediaries. • Basic knowledge of revenue cycle processes. • Ability to provide high-speed DSL or cable modem for a home office. • Minimum internet speed of 25 Mbps download x 10 Mbps upload. • Ability to provide a confidential, HIPAA-compliant, distraction-free workspace.

🏖️ Benefits

• Medical insurance • Dental insurance • Vision insurance • Short-term disability • Long-term disability • Group term life insurance • Optional voluntary benefits • Employee Wellness rewards program • Gift cards through wellness participation • Remote work / virtual work arrangement