PFS Quality Assurance Specialist

Department Name:

Amb Billing & Follow Up

Work Shift:

Day

Job Category:

Revenue Cycle

Estimated Pay Range:

$19.06 - $28.60 / hour, based on location, education, & experience.

In accordance with State Pay Transparency Rules.

A rewarding career that fits your life. Those who have joined the Banner mission come from all walks of life, united by the common goal: Make health care easier, so life can be better. If changing health care for the better sounds like something you want to be part of, apply today.

Revenue Integrity has become a leading national focus to gain greater visibility for sound financial outcomes/practices, compliance and optimal reimbursement with focus across all continuums of patient care. Revenue Integrity in an integral part of the Revenue Cycle and covers all essentials related to it. We have teams comprised of Charge Capture, Pre-bill, Post-bill and

Monitoring (Auditing). RI also utilizes technology to enhance achievement along with an added focus where necessary that may include high dollar accounts, denials, improved A/R days and cash flow while collaborating with many areas such as Billing, Coding, CDM Services Expected reimbursement.

As the PFS Quality Assurance Specialist, you will perform analysis and audits of registration functions that support Patient Financial Services and ensure compliance with billing requirements.

Monday - Friday 8 Hour Days, some flexibility in start times

This can be a remote position if you live in the following state(s) only:

AL, AK, AR, AZ, CA, CO, FL, GA, IA, ID, IN, KS, KY, LA, MD, MI, MN, MO, MS, NC, ND, NE, NH, NY, NM, NV, OH, OK, OR PA, SC, TN, TX, UT, VA, WA, WI, WV, WY

Within Banner Health Corporate, you will have the opportunity to apply your unique experience and expertise in support of a nationally-recognized healthcare leader. We offer stimulating and rewarding careers in a wide array of disciplines. Whether your background is in Human Resources, Finance, Information Technology, Legal, Managed Care Programs or Public Relations, you'll find many options for contributing to our award-winning patient care.

POSITION SUMMARY
This position performs analysis and audits of registration functions that support Patient Financial Services and ensure compliance with billing requirements.
CORE FUNCTIONS
1. Analyzes demographic and financial information documented by the registration staff, audits work and determines registration accuracy rates. Maintains standards of audit and accuracy compliance as required by federal, state and company regulations and requirements.
2. Creates and produces regular and ad hoc reports and performance analyses. Determines accuracy rates for individual registrars.
3. Collects, sorts and interprets patient demographic and financial information. Defines, documents and reports problems discovered during analysis of registration information.
4. Acts as a knowledge resource to the registration staff as to requirements for compliance with specific regulatory and accreditation requirements for federal, state and third party agencies. Pursues and participates in education to remain current with changes in the healthcare and insurance industries. As assigned, provides training for registration staff.
5. As assigned, provides patient services work, performs pre-registration and registration processes, participates in performance improvement activities, committees, teams or work groups to enhance department operations and performs additional or related duties as required, assigned or requested.
6. Works independently under general supervision, leads and follows structured work routines. Holds responsibility for all audit and correction requirements. Works in a fast paced, multi task environment with high volume and immediacy needs requiring independent decision making and sound judgment to prioritize work and ensure appropriateness and timeliness of each patient’s care. This position requires the ability to retain large amounts of changing payor information/knowledge crucial to attaining reimbursement for the services provided. Primary external customers include patients and their families, physician office staff and third party payors.
MINIMUM QUALIFICATIONS
High school diploma/GED or equivalent working knowledge.
Requires two or more years of diversified experience in hospital Patient Registration/Financial Services work. Knowledge of medical terminology and a broad understanding of all common insurance and payor types and authorization requirements. Must have highly developed interpersonal skills and communications skills for working with patients and patient families.
Requires accurate and efficient keyboarding skills, the ability to work effectively with common office software, and to create reports from the medical records database system.
PREFERRED QUALIFICATIONS
Additional related education and/or experience preferred.

Anticipated Closing Window (actual close date may be sooner):

2025-08-21

EEO Statement:

EEO/Female/Minority/Disability/Veterans

Our organization supports a drug-free work environment.

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