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Senior Patient Accounting Specialist – Physician Billing
INTEGRIS Health. Process complex transactions, payment files, claims, insurance collections, and physician charge entry .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in healthcare billing, collections, and denials management, with a strong understanding of regulations, compliance, and payer relationships. Proficient in analyzing complex transactions and preparing detailed reports while ensuring adherence to HIPAA and other legal standards.
Highest-signal resume keywords
Healthcare Billing ExperienceDenials Management ExpertiseKnowledge of ICD-10 and CPT-4Healthcare Certification (CRCR, CRCS, CHAA)Proficiency in Microsoft Office
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Claims ProcessingPayment ProcessingAuditing and AppealsData AnalysisReport PreparationThird-Party Payer RelationsLegal Document KnowledgeBilling Software ProficiencyHealthcare ComplianceRevenue Cycle Management
Soft Skills
Effective CommunicationProblem SolvingCollaborationDecision MakingFeedback Provision
Tools & Technologies
Billing and Claims Management SoftwareMicrosoft Office
Certifications & Qualifications
CRCRCRCSCHAA
Industry Keywords
HealthcareMedicareMedicaidThird-Party ContractsNCQA GuidelinesFair Debt Collection PracticesFederal RegulationsState RegulationsDRGUB04/CMS-1500
About the role
Key responsibilities & impact- Process complex transactions, payment files, claims, insurance collections, and physician charge entry
- Review and resolve denied, underpaid, and overpaid claims and carry out appeals
- Maintain third-party payer relationships and respond to inquiries, complaints, and correspondence
- Execute auditing and denial appeals processes with third-party and government payers
- Monitor payer files for accuracy and update documentation
- Research claims, best practices, and policy reforms
- Work with internal departments and external organizations to resolve complex accounts
- Maintain data on payer issues, underpayments, banking errors, and payment trends
- Prepare, maintain, and submit reports
- Make complex decisions independently within the scope of the position
- Participate in service, process, and quality improvement activities
- Provide feedback to management on revenue opportunities and payer standards
- Maintain knowledge of regulations, compliance requirements, HIPAA, and INTEGRIS Health policies
- Contribute to testing system modifications and coordinate with IT staff and department managers
- Participate in professional development
- Report to the department manager or supervisor
Requirements
What you’ll need- 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 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)
- Must follow standard precautions
- Potential exposure to infections and communicable diseases, blood and body fluids, electrical equipment, and chemicals
Benefits
Comp & perks- Front-loaded PTO
- Medical benefits through the extensive INTEGRIS Health network
- Financial assistance for continued education
- 24/7 mental health support
- Career and development opportunities