Patient Accounting Denials Specialist I-ABQ
 Presbyterian Healthcare Services | |
life insurance
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 United States, New Mexico, Santa Fe | |
 Feb 04, 2026 | |
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Location Address: Remote Office Santa Fe, NM 87501Compensation Pay Range: Minimum Offer $15.87 Maximum Offer $23.04 Now Hiring: Patient Accounting Denials Specialist I-ABQSummary: Responsible for root cause analysis and next step resolution of denials. Performs a variety of duties, including A/R follow-up, appeals, customer service, processing of correspondence, and daily reconciliation of activities. Type of Opportunity: Full time Job Exempt: No Job is based: Remote Workers New Mexico Work Shift: Days (United States of America)Responsibilities: * Performs denial follow-up activities for assigned payors utilizing work queues.* Submits corrected claims, reconsiderations and/or appeals to overturn denials. * Responsible for providing any information (medical records, itemized statements, etc.) requested by insurance companies to process claims and overturn denials. * Must follow process/procedures to ensure timely follow up on outstanding denials. * Document accounts in accordance with established PHS policies/procedures. * Knowledgeable in various computer systems (i.e. Electronic Health Record, claims clearinghouse, FISS/DDE, Payer portals, Microsoft Office Suite.) * Must utilize communication skills to be an effective team member. * Must actively participate in team meetings and take a proactive approach to communicate work related ideas and concerns. * Must develop and maintain professional work relationships with team members, PHS departments and outside agencies. * Maintains strictest confidentiality, adheres to all HIPAA and CMS compliance rules and regulations. * Perform other duties as assigned by the Denial Supervisor and/or Manager. Qualifications: High school degree or GED required, short-term training on insurance collections and claims processing. Minimum two yearsA experience in insurance follow-up, billing, and collections. Demonstrated ability to communicate effectively via telephone and in writing and be computer literate.Must be passionate about being part of an organization focused on continuously improving patient experiences and the health of our community. Experience with Microsoft Office Suite products preferred. Excellent organizational, problem-solving, verbal, and written communication skills, along with, attention to detail and the ability to interact effectively with other functional areas and management teams are required. Must have a strong work ethic and demonstrated ability to work effectively in a team environment. Must be able to prioritize and manage a high-volume workload and be able to work in a fast-paced environment and contend with continually changing payer regulations and requirements. All benefits-eligible Presbyterian employees receive a comprehensive benefits package that includes medical, dental, vision, short-term and long-term disability, group term life insurance and other optional voluntary benefits. Wellness Why work at Presbyterian? About Presbyterian Healthcare Services Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans. AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses. We're Determined to Support New Mexico's Well-Being | Presbyterian Healthcare Services | |