Nurse Consultant, QM
CVS Health
Patient Accounting Specialist
INTEGRIS Health
full-time
Posted on:
Origin: • 🇺🇸 United States • Oklahoma
Visit company websiteJob Level
Junior
About the role
- Responsible for importing and processing of payment files, claim processing, collection of insurance or patient balances, physician charge entry
- Maintain and manipulate multiple files or work lists as assigned
- Communicates directly with Payers to follow-up on outstanding claims to resolve payment variances and achieve timely reimbursement
- Provides payers with specific reasons for suspected underpayments and analyzes reasons given by payers for non-payment
- Updates and maintains accurate information on each account with action plan for next steps to resolve
- Effectively handles all communications, including telephone and email from payers and departments within the health system
- Participates in continuous quality improvement efforts, establish goals with supervisors and track progress
- Understands and maintains compliance with HIPAA guidelines when handling patient information
- Understands federal and state regulations and specific payer requirements and explanations of benefits to identify and report billing compliance issues and payer discrepancies
- Assists hospital and/or physician patients who come to the patient accounting office during business hours
- Reports to the manager or supervisor of the department as assigned
- May have additional or varied physical demand and/or respiratory fit test requirements
- Office environment with no known exposures to hazardous material
Requirements
- 1 year of insurance, billing and collections or related business environment
- May consider successful completion of 1100+ related Career Tech program (medical billing/coding or accounting/bookkeeping) in lieu of experience
- College coursework in related field or Healthcare Certification (CRCR, CRCS, CHAA) preferred
- Previous experience with medical terminology, basic ICD10 and CPT coding preferred
- Previous experience using Microsoft Office programs
- Previous experience in one of the following: billing, insurance resolution follow-up, cash posting, or customer service preferred
- Must be able to communicate effectively in English (verbal/written)
- Study level: High School Graduate
