PFS Billing Specialist

Presbyterian Healthcare Services

Claims Submission Specialist ensuring timely and compliant insurance claims processing at Presbyterian. Collaborating across departments and systems to resolve billing discrepancies and improve patient experiences.

Posted 4/15/2026full-timeRemote • New Mexico • 🇺🇸 United StatesMid-LevelSenior💰 $16 - $23 per hourWebsite

About the role

Key responsibilities & impact

Prepare, process, and submit accurate and timely insurance claims for all payer types
Resolve pre‑billing edits and route accounts to appropriate departments when additional review is needed
Review and clear assigned work queues promptly to meet key performance indicators
Document all account activity in alignment with PHS policies and procedures
Contact insurance companies, patients, and employer groups to obtain required information for claim submission
Notify leadership of billing issues involving internal departments or contracted vendors
Submit both electronic and paper primary and secondary claims, including required HIPAA‑compliant attachments, medical records, and supporting forms
Stay current on billing procedure changes that impact claim processing or reimbursement

Requirements

What you’ll need

High School Diploma or GED required
Less than 1 year of clerical or customer service experience preferred
Proficiency with Microsoft Office Suite required
Basic knowledge of ICD‑10, HCPCS, CPT, revenue 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
Ability to maintain a HIPAA‑compliant, confidential home workspace with reliable high‑speed internet (minimum 25 Mbps download / 10 Mbps upload)

Benefits

Comp & perks

Health insurance
Dental insurance
Vision insurance
Short-term and long-term disability
Group term life insurance
Employee Wellness rewards program

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

insurance claims processingICD-10HCPCSCPTrevenue codesUB-04HCFA-1500 claim formselectronic transactionscoordination of benefitsMedicare MSPQ

Soft Skills

customer servicecommunicationproblem-solvingattention to detailtime managementorganizational skillsconfidentialityadaptabilityteam collaborationleadership

Certifications

High School DiplomaGED