INTEGRIS Health ir Oklahomas štatam piederoša veselības aprūpes sistēma, kas apkalpo kopienas visā štatā, izmantojot slimnīcas, rehabilitācijas centrus, ārstu klīnikas, garīgās veselības aprūpes iestādes, neatliekamās aprūpes punktus, mājas veselības aprūpes aģentūras, fitnesa centrus un patstāvīgas dzīves kopienas. Tās darbība apvieno plašu veselības aprūpes profesionāļu tīklu, kas koncentrējas uz palīdzību Oklahomas ģimenēm dzīvot veselīgāk, nodrošinot līdzjūtīgu un kvalitatīvu aprūpi. Organizācija piedāvā arī karjeras iespējas dažādās veselības aprūpes jomās un atbalsta funkcijās.
Senior Patient Accounting Specialist, Physician Billing
Resolve physician billing denials, appeals, and reimbursement issues as a senior patient accounting specialist at INTEGRIS Health, Oklahoma’s largest not-for-profit health system.
Apraksts
- Handle complex billing transactions, including transplant cases, payer audits, withholds, and data from multiple sources.
- Investigate denied, underpaid, and overpaid claims, and manage appeals.
- Maintain relationships with third-party payers and address inquiries, complaints, and correspondence about denials, appeals, payments, and audits.
- Process payment files and claims, collect insurance, and enter physician charges as needed.
- Manage audit and denial appeals from intake and assessment through documentation, tracking, response, and resolution.
- Check payer files for accuracy and keep documentation current.
- Research claims, records, best practices, and policy changes.
- Communicate accurately with internal teams and external parties.
- Partner with internal departments and external organizations to resolve complex accounts.
- Track payer issues, underpayments, banking errors, and payment trends.
- Prepare, maintain, support, and submit reports.
- Make complex decisions independently within the position’s scope.
- Contribute to service, process, and quality improvement efforts.
- Advise management on revenue opportunities and payer standards.
- Stay current on state and federal regulations, compliance obligations, and INTEGRIS Health policies, including fraud and abuse, confidentiality, and HIPAA.
- Support system change testing and coordinate implementation with IT staff and department managers.
- Take part in professional development.
- Report to the assigned department manager or supervisor.
Prasības
- At least four years of experience in healthcare billing, collections, payment processing, or denial management; denial management experience is preferred.
- Experience in at least three healthcare areas is preferred, such as billing, collections, denials, or registration.
- Healthcare certification such as CRCR, CRCS, or CHAA is 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.
- Experience with Microsoft Office and billing or claims management software.
- Experience with hospital and physician billing and reimbursement; Medicare, Medicaid, and commercial payer denials and appeals; third-party contracts; NCQA denial and appeal guidelines; federal and state denial and appeal regulations; and Fair Debt Collection Practices.
- Effective spoken and written English communication skills.
- Ability to follow standard precautions.
Priekšrocības
- Front-loaded paid time off.
- Medical coverage through the INTEGRIS Health network.
- Financial assistance for continuing education.
- 24/7 mental health support.
- Career development opportunities.