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

UnitedHealth Group•Pearland, TX

2d•$18 - $32•Hybrid

About The Position

Kelsey-Seybold Clinic, part of the Optum family of businesses, is seeking an Insurance Follow-Up Representative to support physician billing and collection of third-party accounts receivable. Under the supervision of the Business Office Supervisor, the representative researches assigned unresolved accounts using medical software, the EHR, and third-party payer websites; refiles or appeals claims; submits additional medical documentation; and monitors account status. The role is responsible for an inventory of more than $1 million in insurance receivables. The representative initiates contacts and negotiates appropriate resolutions, handles inquiries and correspondence from third parties and patients, and analyzes, audits, reconciles, and resolves accounts. Duties must comply with federal and state billing guidelines, contractual obligations, and department policies and procedures. The role requires dependability and independent work, composure under deadlines and interruptions, and professional, courteous communication with patients and external contacts. Patient-facing support includes explaining financial liability and non-coverage, processing payments and payment plans, and clarifying explanations of benefits and physician-service statements to help provide a positive service experience. This position combines onsite office work and remote work. Candidates must be local to the Houston area and available for regular onsite work. The employer describes opportunities for performance recognition and development for other roles.

Requirements

High school diploma or GED from an accredited program.
At least 3 years of current experience in a health care billing and collection environment or relevant health care setting using an accounting or health care computer system; alternatively, at least 2 years of related experience with preferred education.
Basic PC and Internet literacy.
Knowledge of medical terminology and application of CPT and ICD coding.
Working knowledge of major third-party payers and their websites.
Ability to interpret explanations 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 varied tasks quickly and with attention to detail and accuracy.
Dependability and ability to work independently, retain composure, meet deadlines, and resolve problems in a fast-paced environment with interruptions.
Candidates must be local to the Houston area for regular onsite work.
Must pass a drug test before beginning employment.

Nice To Haves

Epic Professional Billing experience.
At least 5 years of experience in a health care billing and collection environment or relevant health care setting using an accounting or health care 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 and monitor assigned unresolved third-party accounts using medical software, the EHR, and payer websites.
Refile or appeal claims and submit additional medical documentation.
Manage an inventory of more than $1 million in insurance receivables.
Initiate internal and external contacts and negotiate appropriate account resolutions.
Respond to and resolve inquiries and correspondence from third parties and patients.
Analyze, audit, problem-solve, and reconcile accounts.
Comply with federal and state billing guidelines, contractual obligations, and department policies and procedures.
Communicate with patients and external contacts about financial liability, non-coverage, payments and payment plans, explanations of benefits, and physician-service statements.