Insurance Follow-Up Representative II-Kelsey Seybold Clinic-Pearland Administrative Office

UnitedHealth Group-posted 4 months ago

$17 - $31/Yr

Full-time • Entry Level

Pearland, TX

5,001-10,000 employees

Insurance Carriers and Related Activities

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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.

Responsible for an inventory of over a $1M in insurance receivables
Initiate contacts and negotiate appropriate resolution (internal and external) as well as receive and resolve inquiries and correspondence from third parties and patients
Ability to analyze, audit, problem solve and reconcile an account is critical to this position
Conducts duties in accordance with industry federal and state billing guidelines and contractual obligations and in compliance with department policies and procedures
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

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 using an accounting/health care computer system or two years of related experience with preferred education
Demonstrated basic PC and Internet literacy
Medical Terminology, CPT & ICD coding application experience
Experience with interpreting Explanation of Benefits (EOB's), physician billing statements
Proven good analytical and mathematical ability
Proven excellent interpersonal communications skills and ability to communicate effectively both orally and in writing with patients, physicians, management, and third-party representatives
Ability to handle a variety of tasks with speed, attention to detail and accuracy
Proven working knowledge of major third-party payers and their websites

Associate's degree in business administration or related field; or successful completion of Coding and Billing Certificate Program
5+ years of experience in a health care billing and collection environment or relative health care setting using an accounting/health care computer system in area of specialty
Proven 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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