Senior Patient Accounting Specialist
INTEGRIS Health
full-time
Posted on:
Location Type: Hybrid
Location: Oklahoma City • Oklahoma • 🇺🇸 United States
Visit company websiteJob Level
Senior
About the role
- Responsible for importing and processing of payment files, claim processing, collection of insurance, and/or physician charge entry
- Executes the auditing, denial appeals process, which includes receiving, assessing, documenting, tracking, responding to, and/or resolving appeals with third-party and government payers in a timely manner
- Monitors payer files for accuracy, ensures payer documentation is completed and assist in updating files with pertinent information as necessary
- Conducts relevant research to assist with resolving files or claims and to stay informed on best practices and policy reforms
- Conducts internal and external correspondence accurately, clearly, concisely, and professionally while following organizational regulations
- Works with internal departments and external organizations to resolve complex accounts
- Maintains data for trending purposes on payer issues, underpayments, banking errors, payment trends and collaborates with team members to make recommendations for improvements and resolving issues
- Prepares, maintains, assist with, and submits reports as required
- 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
- 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
- Pinpoints improvement opportunities and contributes to the testing of system modifications; works closely with IT staff and department managers to ensure proper implementation
- Participates in professional development to enhance job knowledge and performance
- Reports to the manager or supervisor of the department as assigned
- Potential for exposure to infections and communicable diseases, blood and body fluids, electrical equipment, chemicals; must follow standard precautions
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)
Benefits
- front loaded PTO
- 100% INTEGRIS Health paid short term disability
- increased retirement match
- paid family leave
- career and development opportunities
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
healthcare billingcollectionspayment processingdenials managementDRGICD-10CPT-4UB04claims management softwarereport preparation
Soft skills
communicationcollaborationproblem-solvingindependent decision-makingattention to detailprofessionalismresearchprocess improvementorganizational skillstime management
Certifications
CRCRCRCSCHAA