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Pfs Jobs (NOW HIRING)

PFS Group

Insurance Appeals Rep

Houston, TX · On-site

CUBS experience PFS Group Nationwide Patient Account Management Firm. Based in Houston, Texas, we currently work with 32+ clients who operate more than 100 hospital facilities from small, rural ...

PFS Group

Customer Service Representative

Uvalde, TX · On-site

$13/hr

At PFS Group, one of the nation's fastest-growing patient financial services companies, we help patients understand and resolve their medical bills with clarity while delivering exceptional customer ...

PFS Group

Customer Service Representative

Uvalde, TX

$13/hr

At PFS Group, one of the nation's fastest-growing patient financial services companies, we help patients understand and resolve their medical bills with clarity while delivering exceptional customer ...

PFS Group

Customer Service Representative

Houston, TX · On-site

$14 - $19.25/hr

At PFS Group, one of the nation's fastest-growing patient financial services companies, we help patients understand and resolve their medical bills with clarity while delivering exceptional customer ...

Ahold Delhaize

FT Lead PFS - 6529 (539810)

Enola, PA · On-site

FT Lead PFS - 6529 The GIANT Company is an equal opportunity employer. We comply with all applicable federal, state, and local laws. Qualified applicants are considered without regard to sex, race ...

PFS Group

Customer Service Representative

Houston, TX · On-site

$14 - $19.25/hr

At PFS Group, one of the nation's fastest-growing patient financial services companies, we help patients understand and resolve their medical bills with clarity while delivering exceptional customer ...

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How much do pfs jobs pay per hour?

As of Sep 4, 2026, the average hourly pay for pfs in the United States is $20.66, according to ZipRecruiter salary data. Most workers in this role earn between $17.31 and $23.08 per hour, depending on experience, location, and employer.

What is a PFS job?

PFS typically stands for Patient Financial Services in healthcare, referring to roles that manage and oversee patient billing, insurance claims, and payment processing. PFS professionals ensure that healthcare providers are reimbursed for their services by handling account management, resolving billing issues, and communicating with insurance companies and patients. These positions require knowledge of medical billing codes, insurance procedures, and strong customer service skills. PFS jobs are essential for the financial operations of hospitals and clinics.

What are the key skills and qualifications needed to thrive as a Patient Financial Services specialist?

To thrive as a Patient Financial Services (PFS) Specialist, you need a solid understanding of medical billing, insurance claims processing, and healthcare finance, often supported by a background in healthcare administration or related fields. Familiarity with revenue cycle management systems, billing software such as Epic or Cerner, and knowledge of HIPAA regulations are typically required. Strong attention to detail, excellent communication skills, and the ability to handle sensitive information with discretion make someone stand out in this position. These skills are vital to ensure accurate billing, timely reimbursement, and compliance with industry standards, directly impacting a healthcare facility's financial health.

What are some common challenges faced by Patient Financial Services professionals, and how can they be addressed?

Patient Financial Services (PFS) professionals often face challenges such as managing complex insurance claims, staying updated with frequent regulatory changes, and maintaining accurate patient billing. To address these issues, staying current with industry training, utilizing advanced billing software, and fostering clear communication with both patients and insurance providers are critical. Additionally, teamwork and regular process reviews can help ensure accuracy and improve patient satisfaction.
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Pfs jobs near you
Infographic showing various Pfs job openings in the United States as of August 2026, with employment types broken down into 91% Full Time, 7% Part Time, 1% Contract, and 1% Nights. Highlights an 82% Physical, 4% Hybrid, and 14% Remote job distribution, with an average salary of $42,978 per year, or $20.7 per hour.

Insurance Appeals Rep

PFS Group

Houston, TX • On-site

Full-time

Medical, Dental, Vision, Life, Retirement

Re-posted 20 days ago

Key responsibilities

  • Review high dollar or complex denials for hospital insurance claims and draft timely appeals.

  • Research payer guidelines, clinical documentation, and remittance advice to support appeals and determine denial reasons.

  • Follow appeals through to resolution, track payer issues, and work to resolve unpaid balances.

Job description

JOB SUMMARY

Under the supervision of the Insurance Supervisor, the Insurance Appeals Representative will work high dollar or complex denials for hospital insurance claims. The Appeals Representative will be responsible for reviewing basic clinical documentation and relevant payer guidelines to draft timely and effective appeals. They will be measured on appeals success and denials overturn rate, working to improve cash collections on behalf of their client(s). The Appeals Representative may directly write appeals or act as a consultant for other Insurance Reps, assisting them with referencing clinical or payer guidelines. They may be expected to share payer updates with Insurance teams or provide occasional information sessions to department trainer or representatives. They will prioritize work based on feedback from their leadership in order to best impact performance metrics.

ESSENTIAL FUNCTIONS

  1. Demonstrate extensive knowledge of insurance follow-up and denials.
  2. Act as the subject matter expert for appeals on their team.
  3. Triage and determine denial reasons from remittance advice, explanation of benefits, payer portals, or other avenues of information.
  4. Research pertinent payer medical policy bulletins and billing guidelines, creating a repository of reference materials for themselves and other team members.
  5. Prioritize work effort by viability and amount of payment to maximize cash.
  6. Track payer issues and escalations to provide relevant trending information to leadership.
  7. Follow appeals to resolution to assess effectiveness.
  8. Create job aids and share information on appeals language as needed.
  9. Practice compliant billing and follow-up strategies for all government and managed care payers.
  10. Meet minimum of 10 appeals per day, as well as any follow-up needed on existing appeals.
  11. Aggressively seek to resolve unpaid balances.
  12. Document all efforts accurately and thoroughly.
  13. Follow all workflow protocols.
  14. Work other insurance inventory as assigned or as volume demands.

KNOWLEDGE, SKILLS, AND ABILITIES

  1. Outstanding research and follow-up skills.
  2. Deep knowledge of denial types and causes.
  3. Ability to research commercial, managed care, and government payer guidelines and reference language in all appeals.
  4. Ability to read and interpret remittance advice/explanation of benefits.
  5. Strong written and verbal communication skills, especially when drafting appeals or creating workflow templates for teammates.
  6. Self-motivation and ability to work autonomously.
  7. Basic analytics, to include Microsoft Excel.

EDUCATION AND EXPERIENCE

  1. At least 6 months as an Insurance Representative at PFS Group, or 12 months of equivalent experience from a comparable organization.
  2. At least 2 years of hospital insurance follow-up or denials experience.
  3. Epic experience, with strong preference toward HB, required.

Preferences 

  1. CUBS experience

PFS Group

Nationwide Patient Account Management Firm.

Based in Houston, Texas, we currently work with 32+ clients who operate more than 100 hospital facilities from small, rural community medical centers to metro population center health systems. Leaders in their respective markets and nationwide, our clients rely on our services to support their accounts receivable departments.

PFS Group offers a friendly, caring work environment, with competitive benefits and compensation, (medical, dental, vision, short and long-term disability, life insurance, hospital indemnity, critical illness, accident insurance and a matching 401(k) and Zayzoon!

If you are looking for a position in a dynamic, fast-paced organization with career growth opportunities, come grow with us! www.pfsgroup.org

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