Patient Accounting Spec
INTEGRIS Health
Senior Patient Accounting Specialist
INTEGRIS Health
full-time
Posted on:
Origin: • 🇺🇸 United States • Oklahoma
Visit company websiteJob Level
Senior
About the role
- INTEGRIS Health, Oklahoma’s largest not-for-profit health system has a great opportunity for a Patient Accounting Spec Sr in Oklahoma City, OK. In this position, you’ll work with our Central Business Office Team providing exceptional care to those who have entrusted INTEGRIS Health with their healthcare needs.
- The Patient Accounting Specialist III is responsible for processing complex transactions such as complex services such as global transplant cases, payer audits, payer withholds and managing complex data from multiple sources; reviewing and resolving denied and underpaid/overpaid claims and carrying out the appeals process.
- Maintains and monitors integrity of the claim development and submission process.
- Works to maintain third-party payer relationships, including responding to inquiries, complaints, and other correspondence related to denials, appeals/ payments and audits.
- Regularly makes complex decisions within the scope of the position, and is comfortable working independently.
- Collaborates with team members to continually improve services, and engages in process and quality improvement activities. Provides feedback to management on revenue opportunities and payer standards.
- Maintains thorough knowledge and can communicate effectively state and federal regulations, accreditation/compliance requirements, and INTEGRIS Health policies, including those regarding fraud and abuse, confidentiality, and HIPAA.
- Reports to the manager or supervisor of the department as assigned.
Requirements
- Four years experience in healthcare billing, collections, payment processing, or denials management (denials management experience preferred)
- Understands or has worked in 3+ areas of healthcare such as billing and collections and denials or registration and billing and collections preferred
- Healthcare certification (CRCR, CRCS, CHAA) preferred
- Bachelors Degree preferred
- Previous experience in DRG, ICD-10, CPT-4 and UB04/CMS-1500 claim billing
- Knowledge of legal documents, contract documents, and collection agency procedures and legal procedures
- Previous experience in Microsoft Office and experience with billing and claims management software
- Previous experience with hospital billing and reimbursement, physician billing and reimbursement, Medicare and Medicaid denials and appeals, commercial payer denials and appeals, third-party contracts, NCQA guidelines for denials and appeals, Federal and State regulations relating to denials and appeal and Fair Debt Collection Practices
- Must be able to communicate effectively in English (verbal/written)
