INTEGRIS Health
Patient Accounting Specialist III
Location: Oklahoma City, OK
This role is responsible for processing complex payment transactions, including global transplant cases, payer audits, and managing large datasets. The specialist reviews, resolves, and appeals denied or under/overpaid claims while maintaining relationships with third‑party payers.
Responsibilities
Import and process payment files, perform claim processing, and handle collection of insurance and physician charges.
Execute the auditing and denial appeals process, including documentation, tracking, and resolution.
Monitor payer files for accuracy and update as necessary.
Conduct research to resolve claims and stay informed on best practices and policy reforms.
Maintain professional correspondence with internal and external stakeholders.
Collaborate with departments and external organizations to resolve complex accounts.
Maintain data for trend analysis on payer issues, payment errors, and suggest improvements.
Prepare, maintain, and submit required reports.
Make complex decisions within job scope and work independently.
Drive process and quality improvement activities and provide feedback to management.
Communicate effectively about state/federal regulations, accreditation and compliance, and INTEGRIS policies.
Identify improvement opportunities and support the implementation of system changes.
Participate in professional development.
Qualifications
Minimum four years experience in healthcare billing, collections, payment processing, or denials management.
Experience in at least three healthcare areas such as billing, collections, and denials.
Healthcare certification (CRCR, CRCS, CHAA) preferred.
Bachelor’s degree preferred.
Experience with DRG, ICD‑10, CPT‑4, and UB‑04/CMS‑1500 claim billing.
Knowledge of legal/contract documents, collection procedures, and related practices.
Proficiency in Microsoft Office and billing/claims management software.
Experience with hospital, physician, Medicare, Medicaid, and commercial payer claims and appeals.
Understanding of NCQA guidelines, federal and state regulations, and Fair Debt Collection Practices.
Strong verbal and written English communication skills.
INTEGRIS Health is an Equal Opportunity/Affirmative Action employer. All applicants will receive consideration regardless of protected status as defined by applicable law.
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This role is responsible for processing complex payment transactions, including global transplant cases, payer audits, and managing large datasets. The specialist reviews, resolves, and appeals denied or under/overpaid claims while maintaining relationships with third‑party payers.
Responsibilities
Import and process payment files, perform claim processing, and handle collection of insurance and physician charges.
Execute the auditing and denial appeals process, including documentation, tracking, and resolution.
Monitor payer files for accuracy and update as necessary.
Conduct research to resolve claims and stay informed on best practices and policy reforms.
Maintain professional correspondence with internal and external stakeholders.
Collaborate with departments and external organizations to resolve complex accounts.
Maintain data for trend analysis on payer issues, payment errors, and suggest improvements.
Prepare, maintain, and submit required reports.
Make complex decisions within job scope and work independently.
Drive process and quality improvement activities and provide feedback to management.
Communicate effectively about state/federal regulations, accreditation and compliance, and INTEGRIS policies.
Identify improvement opportunities and support the implementation of system changes.
Participate in professional development.
Qualifications
Minimum four years experience in healthcare billing, collections, payment processing, or denials management.
Experience in at least three healthcare areas such as billing, collections, and denials.
Healthcare certification (CRCR, CRCS, CHAA) preferred.
Bachelor’s degree preferred.
Experience with DRG, ICD‑10, CPT‑4, and UB‑04/CMS‑1500 claim billing.
Knowledge of legal/contract documents, collection procedures, and related practices.
Proficiency in Microsoft Office and billing/claims management software.
Experience with hospital, physician, Medicare, Medicaid, and commercial payer claims and appeals.
Understanding of NCQA guidelines, federal and state regulations, and Fair Debt Collection Practices.
Strong verbal and written English communication skills.
INTEGRIS Health is an Equal Opportunity/Affirmative Action employer. All applicants will receive consideration regardless of protected status as defined by applicable law.
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