Hybrid Patient Accounting Specialist

at INTEGRIS Health

• Job title: Patient Accounting Specialist
• Job type: Full Time
• Experience level: Mid level, Senior
• Salary: Not specified
• Degree requirement: High School Diploma
• Location requirements: Hybrid, Oklahoma City, United States

About the role

• Patient Accounting Specialist role at INTEGRIS Health managing healthcare billing and collections in Oklahoma City. Providing expertise on claims and reimbursement processes.

Responsibilities

• * Reviews, evaluates and works with HIM and other applicable departments to resolve questions related to medical codes, modifiers, and/or other elements present or missing on the claim.
• * Assists with receipt of correspondence related to EOBs, payer notices and payer audits/record reviews.
• * Analyzes payment rates and claim processing by third party payers and governmental agencies for accuracy during the claim monitoring process and ensures timely follow-up to recover any underpayment.
• * Provides feedback to management on revenue opportunities and payer standards.
• * Responsible for importing, processing and reconciling of payment files, claim processing, collection of insurance or patient balances, physician charge entry
• * Maintain and manipulate multiple files or work lists as assigned.
• * Communicates directly with Payers to follow-up on outstanding claims to resolve payment variances and achieve timely reimbursement.
• * Provides payers with specific reasons for suspected underpayments and analyzes reasons given by payers for non-payment
• * Updates and maintains accurate information on each account with action plan for next steps to resolve
• * Effectively handles all communications, including telephone and email from payers and departments within the health system.
• * Participates and recommends areas where performance improvement to processes around third party and government collections are warranted.
• * Understands and maintains compliance with HIPAA guidelines when handling patient information.
• * Maintains thorough knowledge of federal and state regulations as, well as specific payer requirements, explanations of benefits and contract language, in order to identify and report billing compliance issues and payer discrepancies.
• * Assists hospital and/or physician patients who come to the patient accounting office during business hours. Reports to the manager or supervisor of the department as assigned. This position may have additional or varied physical demand and/or respiratory fit test requirements. Please consult the Physical Demands Project SharePoint site or contact Risk Management/Employee Health for additional information. Exposure to hazards is minimal when proper safety procedures are followed. All applicants will receive consideration regardless of membership in any protected status as defined by applicable state or federal law, including protected veteran or disability status.

Requirements

• * 3 years of insurance, billing, collections, denial or related business environment
• * Previous exposure or work experience in 2+ areas of healthcare such as billing and collections or registration and billing preferred
• * 2 years college preferred
• * Healthcare Certification (CRCR, CRCS, CHAA) preferred
• * Previous experience using Microsoft Office programs
• * Previous experience with Medicare, Medicaid, and third party reimbursement rules and regulations, and interpretation of third party payor EOBs preferred
• * Previous experience with ICD-10 and CPT 4 coding and UB04 and/or CMS 1500 claim billing, coding and reimbursement issues and health care program reimbursement and methodologies preferred
• * 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