Sistemul de servicii medicale INTEGRIS Health, deținut de statul Oklahoma, deservește comunitățile din întregul stat prin spitale, centre de recuperare, clinici medicale, unități de sănătate mintală, centre de îngrijire urgentă, agenții de îngrijire medicală la domiciliu, centre de fitness și comunități de locuințe independente. Activitatea sa reunește o rețea extinsă de profesioniști din domeniul sănătății, preocupați să ajute familiile din Oklahoma să ducă o viață mai sănătoasă prin îngrijire empatică și de calitate. Organizația oferă, de asemenea, oportunități de carieră într-o gamă largă de specializări medicale și funcții de sprijin.
Senior Patient Accounting Specialist, Physician Billing
Resolve physician billing denials, appeals, and reimbursement issues as a senior patient accounting specialist. Join INTEGRIS Health, Oklahoma’s largest not-for-profit health system.
Descriere
- Process complex transactions, payment files, claims, insurance collections, and physician charge entries.
- Investigate denied, underpaid, and overpaid claims and pursue appeals.
- Manage relationships with third-party payers and respond to questions, complaints, and correspondence.
- Conduct audits and denial appeals with commercial and government payers.
- Check payer files for accuracy and keep supporting documentation current.
- Research claims, effective practices, and policy changes.
- Coordinate with internal teams and external organizations to resolve complex accounts.
- Track payer issues, underpayments, banking errors, and payment trends.
- Prepare, maintain, and submit reports.
- Make complex decisions independently within the role’s scope.
- Contribute to service, process, and quality improvement efforts.
- Advise management on revenue opportunities and payer standards.
- Stay current on regulations, compliance requirements, HIPAA, and INTEGRIS Health policies.
- Help test system changes and coordinate with IT staff and department managers.
- Take part in professional development.
- Report to the department manager or supervisor.
Cerințe
- At least four years of experience in healthcare billing, collections, payment processing, or denials management; denials management experience is preferred.
- Experience or understanding across three or more healthcare areas is preferred, such as billing, collections, denials, and 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 appeals guidelines; federal and state denial and appeals regulations; and Fair Debt Collection Practices.
- Effective spoken and written English communication skills.
- Ability to follow standard precautions.
- Potential exposure to infections and communicable diseases, blood and body fluids, electrical equipment, and chemicals.
Beneficii
- Front-loaded paid time off.
- Medical coverage through the INTEGRIS Health network.
- Financial assistance for continuing education.
- Mental health support available around the clock.
- Career growth and development opportunities.