Kaizen Lab Inc.
PFS Specialist Lead New Iberia, LA
Kaizen Lab Inc., New Iberia, Louisiana, United States, 70563
Iberia Medical Center (IMC) in New Iberia, LA is looking for team members who will help advance our vision to be the premier hospital of choice for patients, physicians and employees. We've been caring for our community for over 60 years and offer many diverse career paths. Our new employees experience opportunities to learn and grow while caring for their families, friends and neighbors.
SCHEDULE
Full-Time
JOB RELATIONSHIP
WORKERS SUPERVISED: None
SUPERVISED BY: PFS Assistant Manager
QUALIFICATIONS
Education:High school graduate or equivalent.
Licensure/Certification: N/A.
Training and Experience: 2-3 years previous hospital business officeexperience related to the filing and collection of insurance claims. Must have thorough knowledge of insurance reimbursementmethods.
PRINCIPLE TASKS, DUTIES, AND RESPONSIBILITIES
Oversees and assists with audits and appeals initiated by PFS Specialists I and II.
Trains all new PFS Specialists I and II.
Creates and maintains edits within the RCM system.
Leads monthly Psych Huddles.
Prepares reports as requested by the PFS Assistant Manager or Revenue Cycle Manager.
Provides backup support to PFS Specialists I and II, including denial review and research guidance.
Monitors all assigned unpaid accounts—including Commercial, Medicare, Medicare Replacement, Workers’ Compensation, VA, Hospice, and Medicaid—on Monthly ATB reports to ensure timely payment.
Provides backup coverage for Commercial, Medicare, and Medicaid billers for billing and follow-up as needed.
Ensures all unresolved issues on Medicare, Medicaid, and Commercial remittance advices are addressed weekly.
Processes, edits, and prepares over 120 Medicaid claims daily; verifies successful transmission and receipt by Medicaid.
Completes initial billing of all claims generated for inpatient and outpatient Behavioral Health services.
Assists with Contract Management underpayment appeals and related research.
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SCHEDULE
Full-Time
JOB RELATIONSHIP
WORKERS SUPERVISED: None
SUPERVISED BY: PFS Assistant Manager
QUALIFICATIONS
Education:High school graduate or equivalent.
Licensure/Certification: N/A.
Training and Experience: 2-3 years previous hospital business officeexperience related to the filing and collection of insurance claims. Must have thorough knowledge of insurance reimbursementmethods.
PRINCIPLE TASKS, DUTIES, AND RESPONSIBILITIES
Oversees and assists with audits and appeals initiated by PFS Specialists I and II.
Trains all new PFS Specialists I and II.
Creates and maintains edits within the RCM system.
Leads monthly Psych Huddles.
Prepares reports as requested by the PFS Assistant Manager or Revenue Cycle Manager.
Provides backup support to PFS Specialists I and II, including denial review and research guidance.
Monitors all assigned unpaid accounts—including Commercial, Medicare, Medicare Replacement, Workers’ Compensation, VA, Hospice, and Medicaid—on Monthly ATB reports to ensure timely payment.
Provides backup coverage for Commercial, Medicare, and Medicaid billers for billing and follow-up as needed.
Ensures all unresolved issues on Medicare, Medicaid, and Commercial remittance advices are addressed weekly.
Processes, edits, and prepares over 120 Medicaid claims daily; verifies successful transmission and receipt by Medicaid.
Completes initial billing of all claims generated for inpatient and outpatient Behavioral Health services.
Assists with Contract Management underpayment appeals and related research.
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