INSURANCE FOLLOW-UP REPRESENTATIVE II

Kelsey-Seybold Clinic • Pearland, TX

277d • $42,697 - $52,744

About The Position

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. 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.

Requirements

• High School diploma or GED from an accredited program.
• 3 or more years current experience in a health care billing and collection environment or relevant health care setting.
• Basic PC and Internet literacy.
• Medical Terminology, CPT & ICD coding application.
• Good analytical and mathematical ability.
• Excellent interpersonal communications skills.

Nice To Haves

• Associates degree in Business Administration or related field.
• Successful completion of Coding and Billing Certificate Program.
• 5 years experience in a health care billing and collection environment.
• Epic Professional Billing experience.
• Ability to access and retrieve information from the EHR.

Responsibilities

• Research accounts and refile or appeal claims.
• Submit additional medical documentation and track account status.
• Negotiate appropriate resolution for unresolved third-party accounts.
• Receive and resolve inquiries and correspondence from third parties and patients.
• Analyze, audit, problem solve, and reconcile accounts.
• Conduct duties in accordance with industry federal and state billing guidelines.
• Demonstrate dependability and ability to work independently.
• Communicate professionally with external contacts and patients.

Benefits

• Medical, Vision, and Dental
• Tuition Reimbursement
• Company Matching 401K
• Employee Reward and Recognition Program
• Paid time off for vacation, sick, and holidays
• Employee Assistance Program
• Continuing Medical Education allowance

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Industry: Ambulatory Health Care Services
• Education Level: High school or GED