INTEGRIS Health
INTEGRIS Health
INTEGRIS Health — Оклахомаға тиесілі денсаулық сақтау жүйесі. Ол ауруханалар, оңалту орталықтары, дәрігерлік клиникалар, психикалық денсаулық сақтау мекемелері, жедел көмек көрсету орындары, үйде медициналық қызмет көрсету агенттіктері, фитнес орталықтары және тәуелсіз өмір сүру қауымдастықтары арқылы штаттағы қауымдастықтарға қызмет көрсетеді. Оның жұмысы Оклахома отбасыларына жанашыр әрі сапалы медициналық көмек арқылы дені сау өмір сүруге көмектесуге бағытталған денсаулық сақтау мамандарының кең желісін біріктіреді. Ұйым денсаулық сақтау саласының көптеген бағыттары мен қолдау қызметтері бойынша мансап мүмкіндіктерін де ұсынады.

Senior Patient Accounting Specialist, Physician Billing

Resolve complex physician billing claims, payer denials, and appeals at INTEGRIS Health, Oklahoma’s largest nonprofit health system. The role manages reimbursements and payer relationships.

Сипаттама

  • Handle complex transactions, including transplant cases, payer audits and withholds, and data from multiple sources.
  • Investigate denied, underpaid, and overpaid claims, and manage appeals.
  • Maintain third-party payer relationships and address questions, complaints, and correspondence about denials, appeals, payments, and audits.
  • Import payment files, process claims, collect insurance, and enter physician charges as needed.
  • Manage audits and denial appeals from intake and assessment through documentation, tracking, response, and resolution with commercial and government payers.
  • Check payer files for accuracy and keep related documentation current.
  • Research claims, records, best practices, and policy changes.
  • Handle internal and external correspondence in line with organizational rules.
  • Coordinate with internal departments and external organizations to resolve complex accounts.
  • Track data on payer issues, underpayments, banking errors, and payment patterns.
  • Prepare and maintain reports, assist with their preparation, and submit them.
  • Make complex decisions independently within the role’s scope.
  • Take part in service, process, and quality improvement work, and share feedback with management.
  • Stay informed about state and federal regulations, accreditation and compliance requirements, fraud and abuse, confidentiality, HIPAA, and INTEGRIS Health policies.
  • Help test system changes and work with IT staff and department managers on implementation.
  • Take part in professional development.
  • Report to the assigned department manager or supervisor.

Талаптар

  • At least four years of experience in healthcare billing, collections, payment processing, or denials management; denials management experience is preferred.
  • Experience or familiarity across at least three healthcare areas is expected; billing, collections, denials, and registration are preferred areas.
  • Healthcare certifications such as CRCR, CRCS, or CHAA are preferred.
  • A bachelor’s degree is preferred.
  • Prior experience with DRG, ICD-10, CPT-4, and UB-04/CMS-1500 claim billing.
  • Knowledge of legal and contract documents, collection agency procedures, and legal processes.
  • Prior experience with Microsoft Office and billing or claims management software.
  • Prior experience with hospital and physician billing and reimbursement; Medicare, Medicaid, and commercial payer denials and appeals; third-party contracts; NCQA denial and appeal guidelines; relevant federal and state regulations; and Fair Debt Collection Practices.
  • Ability to communicate effectively in spoken and written English.
  • Must follow standard precautions.
  • The role may involve exposure to infections and communicable diseases, blood and body fluids, electrical equipment, and chemicals.

Артықшылықтар

  • Front-loaded paid time off.
  • Medical benefits through the INTEGRIS Health network.
  • Financial assistance for continuing education.
  • Mental health support available 24/7.
  • Career growth and development opportunities.

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