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TRATON GROUPSenior Specialist Accounting/IT
(Senior) Specialist Accounting/IT managing IT interface for TRATON’s accounting team. Involvement in finance process improvement for global operations within S/4HANA.
About the role
- Responsible for importing and processing of payment files, claim processing, collection of insurance, and/or physician charge entry
- Executes the auditing, denial appeals process, which includes receiving, assessing, documenting, tracking, responding to, and/or resolving appeals with third-party and government payers in a timely manner.
- Monitors payer files for accuracy, ensures payer documentation is completed and assist in updating files with pertinent information as necessary.
- Conducts relevant research to assist with resolving files or claims and to stay informed on best practices and policy reforms.
- Conducts internal and external correspondence accurately, clearly, concisely, and professionally while following organizational regulations.
- Works with internal departments and external organizations to resolve complex accounts.
- Maintains data for trending purposes on payer issues, underpayments, banking errors, payment trends and collaborates with team members to make recommendations for improvements and resolving issues.
- Prepares, maintains, assist with, and submits reports as required.
- Regularly makes complex decisions within the scope of the position, and is comfortable working independently.
- Collaborates with team members to continually improve services, and engages in process and quality improvement activities. Provides feedback to management on revenue opportunities and payer standards.
- Maintains thorough knowledge and can communicate effectively state and federal regulations, accreditation/compliance requirements, and INTEGRIS Health policies, including those regarding fraud and abuse, confidentiality, and HIPAA.
- Pinpoints improvement opportunities and contributes to the testing of system modifications; works closely with IT staff and department managers to ensure proper implementation.
- Participates in professional development to enhance job knowledge and performance.
- Conducts relevant research to assist with completing the appeals process and to stay informed on best practices and policy reforms.
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
Job type
Experience level
Salary
Not specified
Degree requirement
Location requirements
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