LogoFresh Jobs Ahead
INTEGRIS Health
INTEGRIS Health
Sponsor pentru viza H1BAsigurare de sănătateAsistență medicalăProduse farmaceutice
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.
LinkedIn
Locurile de muncă ale companiei

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.

USStatele Unite ale AmericiiOKOklahomaHibridNormă întreagăSeniorLimbă Obligatorie: englezăManager contabilitate

Descriere

  • 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.

Cerințe

  • 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.

Beneficii

  • 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.

Locuri de muncă similare

Allstate

Auto Damage Estimator and Supplement Writer

Allstate
Sponsor pentru viza H1BAsigurăriConsultanțăLogistică
USStatele Unite ale AmericiiCTConnecticutFLFloridaKYKentuckyMEMaineMDMarylandMAMassachusettsMIMichiganNHNew HampshireNJNew JerseyNYNew YorkNCCarolina de NordOHOhioPAPennsylvaniaRIRhode IslandSCCarolina de SudVTVermontVAVirginiaWVVirginia de Vest
26 $ – 45 $ / oră
RemoteNormă întreagăNivel mediuSeniorLimbă Obligatorie: englezăRedactor de conținut

Estimate, review, and negotiate auto repair supplements for National General claims, working with body shops across Eastern U.S. states. Most of the role focuses on supplement handling, claim decisions, settlements, and repair estimate quality.

Deschide