Onsite Senior Patient Accounting Specialist

Posted 6 hours ago

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About the role

  • Patient Accounting Spec Sr responsible for complex billing and claims management at INTEGRIS Health. Ensuring effective resolution of claims through expert knowledge and adherence to healthcare regulations.

Responsibilities

  • processing complex transactions such as complex services such as global transplant cases, payer audits, payer withholds and managing complex data from multiple sources
  • reviewing and resolving denied and underpaid/overpaid claims and carrying out the appeals process
  • works to maintain third-party payer relationships, including responding to inquiries, complaints, and other correspondence related to denials, appeals/ payments and audits
  • superior understanding of claims management including provider level benefits, third party payer guidelines and contracts, state/federal laws and all other functions of the job
  • maintains and monitors integrity of the claim development and submission process

Requirements

  • Four years experience in healthcare billing, collections, payment processing, or denials management (denials management experience preferred)
  • Understands or has worked in 3+ areas of healthcare such as billing and collections and denials or registration and billing and collections preferred
  • Healthcare certification (CRCR, CRCS, CHAA) preferred
  • Bachelors Degree preferred
  • Previous experience in DRG, ICD-10, CPT-4 and UB04/CMS-1500 claim billing
  • Knowledge of legal documents, contract documents, and collection agency procedures and legal procedures
  • Previous experience in Microsoft Office and experience with billing and claims management software
  • Previous experience with hospital billing and reimbursement, physician billing and reimbursement, Medicare and Medicaid denials and appeals, commercial payer denials and appeals, third-party contracts, NCQA guidelines for denials and appeals, Federal and State regulations relating to denials and appeal and Fair Debt Collection Practices
  • Must be able to communicate effectively in English (verbal/written)

Benefits

  • front loaded PTO
  • 100% INTEGRIS Health paid short term disability
  • increased retirement match
  • paid family leave

Job title

Senior Patient Accounting Specialist

Job type

Experience level

Senior

Salary

Not specified

Degree requirement

High School Diploma

Location requirements

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