Senior Patient Accounting Specialist - Days

Role Overview

• processing complex transactions 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
• maintaining 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
• maintaining and monitoring 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