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Senior Patient Accounting Specialist – Physician Billing
INTEGRIS Health. Process complex transactions including global transplant cases, payer audits, payer withholds, and complex data from multiple sources .
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 regulatory compliance and payer relationships. Proficient in processing complex transactions and conducting appeals while maintaining accurate documentation and communication.
Highest-signal resume keywords
Healthcare Billing ExperienceDenials ManagementICD-10 Claim BillingMicrosoft Office ProficiencyHealthcare Certification (CRCR, CRCS, CHAA)
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 ProcessingDenial AuditsData AnalysisReport PreparationLegal Document KnowledgeContract Document KnowledgeBilling Software ProficiencyThird-Party Contract ManagementRegulatory Compliance
Soft Skills
Effective CommunicationProblem SolvingCollaborationAttention to DetailDecision Making
Certifications & Qualifications
CRCRCRCSCHAA
Industry Keywords
HealthcarePayer RelationshipsMedicare DenialsMedicaid DenialsCommercial Payer AppealsNCQA GuidelinesFair Debt Collection PracticesUB04CMS-1500Standard Precautions
About the role
Key responsibilities & impact- Process complex transactions including global transplant cases, payer audits, payer withholds, and complex data from multiple sources
- Review and resolve denied, underpaid, and overpaid claims and conduct the appeals process
- Maintain third-party payer relationships and respond to inquiries, complaints, and correspondence regarding denials, appeals, payments, and audits
- Import and process payment files, process claims, collect insurance, and/or enter physician charges
- Execute denial audits and appeals, including receiving, assessing, documenting, tracking, responding to, and resolving appeals
- Monitor payer files for accuracy and update documentation
- Research claims, files, best practices, and policy reforms
- Conduct accurate and professional internal and external correspondence
- Work with internal departments and external organizations to resolve complex accounts
- Maintain trending data on payer issues, underpayments, banking errors, and payment trends
- Prepare, maintain, assist with, and submit reports
- Make complex decisions independently within the position's scope
- Participate in service, process, quality improvement, and professional development activities
- Communicate regulations, accreditation and compliance requirements, and INTEGRIS Health policies, including fraud and abuse, confidentiality, and HIPAA
- Identify improvement opportunities and help test system modifications with IT staff and department managers
- Report to the department manager or supervisor
Requirements
What you’ll need- Four years experience in healthcare billing, collections, payment processing, or denials management
- Understanding or experience in 3+ areas of healthcare, such as billing and collections, denials, registration, or related areas
- Previous experience in DRG, ICD-10, CPT-4, and UB04/CMS-1500 claim billing
- Knowledge of legal documents, contract documents, collection agency procedures, and legal procedures
- Experience with Microsoft Office and billing and claims management software
- 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, federal and state regulations relating to denials and appeals, and Fair Debt Collection Practices
- Effective English verbal and written communication
- Healthcare certification (CRCR, CRCS, CHAA) preferred
- Bachelor's degree preferred
- Must follow standard precautions; potential exposure to infections, 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