PATIENT FINANCIAL SERVICES REPRESENTATIVE II

Job Details

Job Location: ANCHORAGE, AK 99503Position Type: Full TimeEducation Level: NoneSalary Range: $21.17 - $26.46 HourlyJob Shift: Day

ABOUT ANCHORAGE NEIGHBORHOOD HEALTH CENTER:

At ANHC, we believe everyone deserves high-quality, respectful, and compassionate care, regardless of their ability to pay. As a Federally Qualified Health Center, we serve a diverse patient population with a commitment to health equity and community well-being.

Our culture is grounded in our core values: Respect, Compassion, Personal Integrity, Excellence, and Collaborative Spirit. These values guide how we care for our patients and how we treat one another. We foster a supportive, team-orientated environment where every voice is heard, diversity is celebrated, and staff are empowered to grow and make meaningful contributions. At ANHC, you’ll be part of a mission-driven team that shows up every day with purpose, heart, and a deep commitment to the community we serve.                                                               

PATIENT FINANCIAL SERVICES REPRESENTATIVE POSITION SUMMARY:

Responsible for handling complex daily tasks within the revenue cycle. The PFSR II is expected to have a proficient understanding of coding, denial management and appeals, payment processing, coordination of benefits, and the prioritization and sequencing of payers, contracts, and exclusions. Responsibilities include daily auditing, coding, revenue recovery, and the preparation and submission of insurance claims. Communicates effectively with management about problem areas and suggests potential solutions. Must be able to thrive under pressure to meet deadlines in a fast-paced environment and be available for extra hours, including weekends, as needed.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

• Perform detailed reviews of patient accounts, applying knowledge of medical, dental, laboratory, radiology coding and billing standards to ensure precise account management.
• Receive, evaluate, and input new health care claims into the system. Process payments and apply denials or returns according to policy, ensuring compliance and accurate classification of claims.
• Accurately post payments and adjustments from third-party payers, including Medicare, Medicaid, and Workers’ Compensation, maintaining data integrity and clear account records. Communicate patient financial obligations, including copays, coinsurances, deductibles, out-of-pocket maximums to ensure understanding and accurate applications during billing.
• Audit and post charges across multiple departments, (e.g.  evaluation and management, surgery, radiology, laboratory, behavioral health, and dental) ensuring accuracy in charge capture.
• Identify research and resolve denied/unpaid claims, submitting corrections, and filing appeals timely to recover revenue effectively. Maintain accurate records of denial reasons, actions taken, and resolution outcomes.
• Independently solve complex account issues by applying technical billing standards, working to resolved discrepancies and optimize reimbursement processes.
• Run routine and ad hoc reports, including those for unapplied credits, insurance aging, claim holds, pending charges, and work-in-progress (WIP) accounts, supporting financial tracking and reporting.
• Identify and correctly post suspense accounts and unidentified payments, maintain proper documentation for a clear audit trail.
• Ensure all claims and billing activities align with payer guidelines, third-party reimbursement, and in-network vs. out-of-network rules to maximize compliance and ma support revenue cycle management. Work closely with providers, nursing staff, care coordinators, and eligibility personnel, to ensure smooth patient care and support for optimize billing processes.
• Adhere to HIPAA guidelines and all relevant regulations, ensuring confidentiality and security of patient information during all billing activities,
• Attend regular team meetings, engage in training sessions, and participate in Continuous Quality Improvement (CQI) programs to stay informed on billing practice and enhance the efficiency of denial management.
• Address patient and payer inquiries promptly, providing clear answers r