Float-Professional Billing and Follow-up Team

Title: PBS Float-Professional Billing and Follow-up Team

Location: Portland United States

Job type: Hybrid
Time Type: Full Time
Job id:  25-44604

Job Description:

Pay Range USD $22.97/Hr. - USD $32.84/Hr.

Overview

Your experience in medical billing is enhanced by your compassionate, service-oriented approach. At Legacy, we value both skill and empathy - ensuring our team members can grow professionally while building meaningful connections with patients and colleagues. If you're looking to be part of a healthcare organization that truly strives to make life better for others, we encourage you to consider this opportunity as a Patient Business Services Float.

This is a hybrid-remote position available to residents of Oregon or Washington only. The role follows a rotating schedule requiring on-site work at our NW 31st Business Office one week per month. For the remainder of the schedule, work may be completed remotely.

All new hires are required to visit a designated Legacy Health office in Portland, Oregon prior to their start date to complete a new hire health assessment and onboarding paperwork. Initial training and orientation for this position may be conducted on-site before transitioning to the hybrid schedule.

Responsibilities

Under general supervision, the PBS Float provides flexible staffing support within the Professional Billing and Follow-Up team, covering a variety of roles across Patient Business Services (PBS). These roles include, but are not limited to: Financial Counselor, Biller 1, Biller 2, Biller Lead, Billing Editor, and Account Follow-Up Specialist 2. This position requires a broad and adaptable knowledge base in medical billing, coding, reimbursement practices, claims processing, and payer-specific requirements. The PBS Float plays a critical role in maintaining workflow continuity and supporting operational efficiency across multiple PBS functions.

Billing (Biller 1/Biller 2)

• Edit and prepare claims for accuracy, completeness, and compliance with UB-04 and payer-specific requirements.

• Ensure specialty coding is applied correctly for high-dollar Washington Medicaid cases (e.g., neonate, trauma).

• Coordinate with Medical Health Network (MHN) for pre-pricing of high-dollar claims.

• Follow up with Health Information Services (HIS) to minimize medical coding delays.

• Determine correct payer for capitated claims using matrix-based review of services/revenue codes.

• Verify insurance eligibility for high-value claims (e.g., Secure Horizons, PacifiCare, Welfare).

• Perform charge entry, charge corrections, and payment transfers.

• Reassign claims held in editing queues to appropriate billing teams.

• Submit claims electronically or via hard copy, including necessary documentation (e.g., medical records, TAR forms, itemized bills).

• Address accounts on the Daily Unbilled Report and initiate rebills or interim bills when needed.

• Resolve billing discrepancies, request adjustments, or split bills when appropriate.

• Apply authorized adjustments and write-offs in compliance with Legacy Health policies.

• Provide clear and empathetic customer service to patients and internal stakeholders.

• Communicate with contract liaisons, attorneys, collection agencies, and insurance providers.

• Set follow-up timelines and document billing activity accurately for A/R management.

• May serve as a notary public, process mail, or serve as lead Biller when needed.

Billing Editor

• Review inpatient and outpatient accounts within 3 days of discharge to ensure correct charges before billing.

• Identify and correct errors in donor/auditor accounts and pending bills.

• Research and resolve billing issues, including adjustments for incorrect codes or charges.

• Apply Medicare/Medicaid guidelines to determine proper billing actions (e.g., combining, splitting accounts).

• Act as a resource to departments regarding charge and adjustment procedures.

Account Follow-Up Specialist 2 (Denial Management)

• Resolve complex, high-dollar accounts by investigating claim denials and payer issues.

• Evaluate account details and use independent judgment to determine follow-up strategy.

• Remove processing barriers, rebill claims, transfer payments, and request refunds.

• Negotiate financial arrangements with third-party payers as directed.

• Ensure compliance with Legacy's adjustment and write-off procedures.

• Work with internal departments and external representatives to resolve claim issues efficiently.

Additional Duties

• May serve as backup for other PBS roles or departments.

• May generate or work from various payer-specific reports.

• May assist with training or serve as Biller 2 Lead.

• Maintain professionalism in all communication, including phone, email, and in-person inquiries.

Qualifications

Education:

• High school graduate or equivalent.

Experience:

• Two years of directly applicable healthcare business office experience and/or applicable self pay collection experience.

Skills:

• Demonstrated negotiating, problem-solving and decision-making skills.
• Demonstrated understanding of complex collection issues inherent in high dollar/specialty accounts.
• Demonstrated knowledge of multi-payor systems.
• Demonstrated knowledge of billing/collection rules and regulations.
• Demonstrated familiarity with specialty billing procedures and contracts.
• Demonstrated flair for detail.
• Knowledge of online systems for eligibility and status review of claims.
• Net Typing of 40 wpm and PC based computer skills.
• 10 key proficiency.
• Knowledge of medical terminology.
• Ability to work efficiently with minimal supervision, exercising independent judgment within stated guidelines.
• Demonstrated effective interpersonal skills which promote cooperation and teamwork.
• Ability to withstand varying job pressures and organize/prioritize related job tasks.
• Excellent public relations skills and demonstrated ability to communicate in calm, businesslike manner.
• Ability to adapt to change.

Pay Range

USD $22.97 - USD $32.84 /Hr.

Our Commitment to Health and Equal Opportunity

Our Legacy is good for health for Our People, Our Patients, Our Communities, Our World. Above all, we will do the right thing.

If you are passionate about our mission and believe you can contribute to our team, we encourage you to apply-even if you don't meet every qualification listed. We are committed to fostering an inclusive environment where everyone can grow and succeed.

Legacy Health is an equal opportunity employer and prohibits unlawful discrimination and harassment of any type and affords equal employment opportunities to employees and applicants without regard to race, color, religion or creed, citizenship status, sex, sexual orientation, gender identity, pregnancy, age, national origin, disability status, genetic information, veteran status, or any other characteristic protected by law.