INTEGRIS Health
INTEGRIS Health
INTEGRIS Health yra Oklahomos valstijai priklausanti sveikatos priežiūros sistema, teikianti paslaugas visos valstijos bendruomenėms per ligonines, reabilitacijos centrus, gydytojų klinikas, psichikos sveikatos įstaigas, skubiosios pagalbos punktus, sveikatos priežiūros namuose agentūras, sporto centrus ir savarankiško gyvenimo bendruomenes. Jos veikla apima platų sveikatos priežiūros specialistų tinklą, siekiant padėti Oklahomos šeimoms gyventi sveikiau, teikiant atjaučiančią ir kokybišką priežiūrą. Organizacija taip pat siūlo karjeros galimybių įvairiose sveikatos priežiūros srityse ir pagalbinėse funkcijose.

Senior Patient Accounting Specialist, Physician Billing

Handle physician billing, payer claims, and denial appeals for INTEGRIS Health. The role supports complex revenue cycle operations at Oklahoma’s largest nonprofit health system.

Aprašymas

  • Process complex transactions, including global transplant cases, payer audits and withholds, and data from multiple sources.
  • Review and resolve denied, underpaid, and overpaid claims, and manage appeals.
  • Manage relationships with third-party payers and respond to inquiries, complaints, and correspondence about denials, appeals, payments, and audits.
  • Import and process payment files and claims, collect insurance, and enter physician charges as needed.
  • Conduct denial audits and appeals by receiving, assessing, documenting, tracking, responding to, and resolving appeals.
  • Check payer files for accuracy and keep documentation current.
  • Research claims, files, best practices, and policy changes.
  • Handle internal and external correspondence accurately and professionally.
  • Coordinate with internal departments and external organizations to resolve complex accounts.
  • Track trends in payer issues, underpayments, banking errors, and payments.
  • Prepare, maintain, support, and submit reports.
  • Make complex decisions independently within the scope of the role.
  • Take part in service, process, quality improvement, and professional development activities.
  • Communicate regulations, accreditation and compliance requirements, and INTEGRIS Health policies, including those covering fraud and abuse, confidentiality, and HIPAA.
  • Identify opportunities to improve processes and help IT staff and department managers test system changes.
  • Report to the department manager or supervisor.

Reikalavimai

  • At least four years of experience in healthcare billing, collections, payment processing, or denials management.
  • Understanding of or experience in at least three healthcare areas, such as billing and collections, denials, registration, or related fields.
  • Previous 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.
  • Experience with Microsoft Office and billing and claims management software.
  • Experience with hospital and physician billing and reimbursement; Medicare, Medicaid, and commercial payer denials and appeals; third-party contracts; NCQA guidelines; federal and state rules for denials and appeals; and the Fair Debt Collection Practices Act.
  • Effective spoken and written English communication skills.
  • Healthcare certification such as CRCR, CRCS, or CHAA preferred.
  • Bachelor’s degree preferred.
  • Must follow standard precautions and be able to work around potential exposure to infections, communicable diseases, blood and bodily fluids, electrical equipment, and chemicals.

Privalumai

  • Front-loaded paid time off.
  • Medical benefits through the INTEGRIS Health network.
  • Financial assistance for continuing education.
  • Round-the-clock mental health support.
  • Career growth and development opportunities.

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