Lead PFS Specialist

Clerical/Admin San Marcos, California


Requisition ID
30396
Department
Patient Financial Services
Location
San Marcos, California
Union
Not Applicable
Job Type
Full-Time
Shift
Day
Hours Per Shift
8
Hours Per Pay Period
80

Description
Responsible for day to day operational workflow to ensure the Billing team has necessary resources to achieve cash collection goal for their respective payer groups. Including, but not limited to billing/submission and/or follow-up of claims and clerical functions as necessary. Involves interaction with various acute facility departments, patients, outside agencies/facilities and third party payers. Work with management team to ensure staff are informed of regulatory changes and ensures staff workflow modifications are made based on Payer regulation changes and/or Recovery Audit prepayment denials. Inform leadership team of issues and obstacles that prevent timely payment or adjustment posting. Lead open discussion with the team to determine root cause and recommendations for resolution. Provide feedback to leadership based on Recovery Audit and current reimbursement guidelines in order to ensure the cash goal is met. In conjunction with management team, build teamwork through open communication and collaboration among team members. Speak and read English at a level that is sufficient to satisfactorily perform the essential functions of the position. Knowledge of standard office equipment (i.e., calculator, fax, photocopier) and personal computer and computer software skills (i.e., MS Windows, Excel, Access, Word, Powerpoint, internet, e-mail). Windows computer skills including proficient use of keyboarding, use of mouse or keys for functions such as selecting items, use of drop down menus, scroll bars, opening folders, copying and similar operations required upon employment or within the 1st two weeks of employment to perform the essential functions of the job. Performs other duties as assigned. Follows Palomar Health rules, policies, procedures, applicable laws and standards. Carries out the mission, vision, and quality commitment of Palomar Health.

Job Requirements

Minimum Education: High School Diploma and/or combination of education and experience
Preferred Education: Basic college and medical coursework
Minimum Experience: 2 - 3 years healthcare
Knowledge of Medicare and regulatory guidelines and the governing party enforcing legislation
Preferred Experience: 3 - 5 years healthcare
Required Certification: Not Applicable
Preferred Certification: Certified Revenue Cycle Representative
Required License: Not Applicable
Preferred License: Not Applicable

We are an equal opportunity employer and do not discriminate against applicants or employees based on race, color, gender, religion, creed, national origin, ancestry, age, disability, sexual orientation, marital status or any other characteristic protected by law.