Insurance Follow Up Rep II - Kelsey Seybold - Pearland Business Office

UnitedHealth Group•Pearland, TX

11d•$18 - $32•Hybrid

About The Position

The Insurance Follow-Up Representative is responsible for physician billing and collecting third-party account receivables. Using medical software, the EHR, and payor insurance websites, the representative researches assigned unresolved accounts, refiles or appeals claims, submits additional medical documentation, and tracks account status. The position manages an inventory of more than $1 million in insurance receivables and initiates contacts and negotiates appropriate resolutions with internal and external parties. It also handles inquiries and correspondence from third parties and patients. The role requires analyzing, auditing, problem-solving, and reconciling accounts in accordance with federal and state billing guidelines, contractual obligations, and department policies and procedures. The representative communicates professionally and courteously with patients and external contacts about financial liability, non-coverage, payments and payment plans, Explanation of Benefits, and physician service statements. The position is expected to provide a positive patient service experience while working independently, meeting deadlines, and resolving issues in a fast-paced environment with frequent interruptions. This position combines onsite office work and remote work. Candidates must be local to the Houston area for regular onsite work. The employer describes an environment that offers performance recognition, clear direction, and development opportunities.

Requirements

High school diploma or GED from an accredited program.
At least 3 years of current experience in a healthcare billing and collection environment or relevant healthcare setting using an accounting/healthcare computer system, or at least 2 years of related experience with preferred education.
Basic PC and internet literacy.
Knowledge of medical terminology and CPT and ICD coding application.
Working knowledge of major third-party payers and their websites.
Ability to interpret Explanation of Benefits and physician billing statements.
Demonstrated analytical and mathematical ability.
Excellent interpersonal communication skills and ability to communicate effectively orally and in writing with patients, physicians, management, and third-party representatives.
Ability to handle a variety of tasks quickly, with attention to detail and accuracy.
Dependability and ability to work independently, retain composure, meet deadlines, and appropriately analyze, research, and resolve problems.
Candidates must be local to the Houston area for regular onsite work.
Candidates must pass a drug test before beginning employment.

Nice To Haves

Epic Professional Billing experience.
At least 5 years of experience in a healthcare billing and collection environment or related healthcare setting using an accounting/healthcare computer system in the area of specialty.
Understanding of a diversity of insurance plans.
Demonstrated ability to access and retrieve information from the EHR.

Responsibilities

Research, monitor, and analyze assigned unresolved third-party accounts using medical software, the EHR, and payor insurance websites.
Refile or appeal claims and submit additional medical documentation as needed.
Track account status and manage an inventory of more than $1 million in insurance receivables.
Initiate contacts and negotiate appropriate internal and external resolutions.
Receive and resolve inquiries and correspondence from third parties and patients.
Analyze, audit, problem-solve, and reconcile accounts in accordance with billing guidelines, contractual obligations, and department policies and procedures.
Communicate with patients about financial liability, non-coverage, payments and payment plans, Explanation of Benefits, and physician service statements.
Provide professional, courteous service and a positive patient experience.
Meet deadlines and independently research and resolve problems in a fast-paced environment with frequent interruptions.