UnitedHealth Group-posted 4 months ago
$17 - $31/Yr
Full-time • Entry Level
Pearland, TX
5,001-10,000 employees

Explore opportunities with Kelsey-Seybold Clinic, part of the Optum family of businesses. Work with one of the nation’s leading health care organizations and build your career at one of our 40+ locations throughout Houston. Be part of a team that is nationally recognized for delivering coordinated and accountable care. As a multi-specialty clinic, we offer care from more than 900 medical providers in 65 medical specialties. Take on a rewarding opportunity to help drive higher quality, higher patient satisfaction and lower total costs. Join us and discover the meaning behind Caring. Connecting. Growing together. Under the supervision of the Business Office Supervisor, the Insurance Follow-Up Representative is responsible for physician billing and collecting of third-party account receivables using their knowledge of medical software, the EHR, and multiple payors’ insurance websites to research accounts, refile or appeal claims, submit additional medical documentation and track account status by monitoring and analyzing assigned unresolved third-party accounts. The Representative is responsible for an inventory of over a $1M in insurance receivables. They will initiate contacts and negotiate appropriate resolution (internal and external) as well as receive and resolve inquiries and correspondence from third parties and patients. The ability to analyze, audit, problem solve and reconcile an account is critical to this position. This position conducts duties in accordance with industry federal and state billing guidelines and contractual obligations and in compliance with department policies and procedures. Must demonstrate dependability and an ability to work independently. Must be able to retain composure, meet deadlines, and appropriately analyze, research, and resolve problems in a fast-paced environment with constant work-related interruptions. Professionalism and courtesy are expected when communicating with external contacts and patients to explain patient financial liability, advises of non-coverage, process payments and payment plans, clarify Explanation of Benefits and statement of physician services. Exhibits exceptional customer skills to provide the patient with a positive service experience. You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

  • Responsible for physician billing and collecting of third-party account receivables.
  • Research accounts using medical software, EHR, and insurance websites.
  • Refiles or appeals claims and submits additional medical documentation.
  • Tracks account status by monitoring and analyzing unresolved third-party accounts.
  • Initiates contacts and negotiates appropriate resolution.
  • Receives and resolves inquiries and correspondence from third parties and patients.
  • Conducts duties in accordance with industry federal and state billing guidelines.
  • Demonstrates dependability and ability to work independently.
  • Maintains professionalism and courtesy in communications.
  • High School diploma or GED from an accredited program.
  • 3+ years of current experience in a health care billing and collection environment or relevant health care setting.
  • Working knowledge of major third-party payers and their websites.
  • Basic PC and Internet literacy.
  • Medical Terminology, CPT & ICD coding application.
  • Interpreting Explanation of Benefits (EOB’s) and physician billing statements.
  • Proven good analytical and mathematical ability.
  • Proven excellent interpersonal communications skills.
  • Associate’s degree in business administration or related field.
  • 5+ years of experience in a health care billing and collection environment.
  • Understanding of a diversity of insurance plans.
  • Epic Professional Billing experience.
  • Ability to access and retrieve information from the EHR.
  • Comprehensive benefits package.
  • Incentive and recognition programs.
  • Equity stock purchase.
  • 401k contribution.
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