Patient Accounting Specialist - Financial Assistance
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INTEGRIS Health
Oklahoma City, OK (In Person)
Full-Time
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Job Description
INTEGRIS HEALTH
Oklahoma's largest not-for-profit health system has a great opportunity for a Patient Accounting Specialist in Oklahoma City, OK. In this position, you'll work during the day 8-5pm+/- with our team providing exceptional care to those who have entrustedINTEGRIS
Health with their healthcare needs. If our mission of partnering with people to live healthier lives speaks to you, apply today, and learn more about our increased compensation plans and recently enhanced benefits package for all eligible caregivers such as front-loadedPTO, 100
%INTEGRIS
Health paid short-term disability, increased retirement match, and paid family leave. We invite you to join us as we strive to be The Most Trusted Partner for Health. The Patient Accounting Specialist II general responsibilities include facilitating accurate claim submissions according to payer compliance regulations ensuring timely reimbursement from various third-party payers and patients, ensuring proper account documentation in the facility billing system and pursuing follow-up efforts related to follow-up, denials and appeals.INTEGRIS
Health is an Equal Opportunity/Affirmative Action employer. 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.- 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) The Patient Accounting Specialist II responsibilities include, but are not limited to, the following:
- 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.
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