Insurance Follow Up Specialist

UT Health San Antonio•San Antonio, TX

About The Position

Perform follow-up activities on outstanding insurance medical claims for Medicare, Medicaid, Commercial, and Specialty insurance/program payors. Analyze, screen, and correct claim issues; process appeals and write-offs; and determine whether patient billing is necessary. The role works with internal teams and insurance payors to resolve claim issues and support timely reimbursement. UT San Antonio is a public research university serving approximately 42,000 students across 320 academic programs, with 17,000 faculty and staff. The organization describes itself as a Carnegie R1-designated institution focused on advancing knowledge, social mobility, and public health across South Texas and beyond.

Requirements

Some knowledge of patient billing or collection/reimbursement procedures in a healthcare setting is preferred.
Experience in medical claims follow-up, specifically processing insurance claim appeals for various payors.
Detail-oriented, with the ability to organize, prioritize, and coordinate work within schedule constraints and handle emergent requirements promptly.
Ability to multitask in a fast-paced, high-volume environment.
Proficiency in Microsoft Office.
EPIC experience.
Experience with Experian and TriZetto/Claim Logic.
High school diploma or GED.

Nice To Haves

Some knowledge of patient billing or collection/reimbursement procedures in a healthcare setting.

Responsibilities

Initiate follow-up on unresolved appealed or unpaid claims to support maximum and timely reimbursement from Medicare, Medicaid, Commercial, or Specialty insurance/program payors.
Submit appeals and reconsiderations for claim denials through practice management systems, payor portals, or mail.
Analyze daily claim rejections from the clearing house, screen claims for pre-authorization, and request and submit medical records.
Work with Coding, Payment Posting, Managed Care Operations, Provider Enrollment, and Clinical Operations to resolve claim issues.
Review and respond to insurance correspondence concerning recoupments, refunds, eligibility, or other payor requests.
Assist the customer service team with patient billing concerns or disputes.
Verify patient benefits and insurance eligibility, verify claim status, review payor guidelines on insurance websites, and communicate findings to insurance companies, management, and clinical departments.
Complete other duties as assigned.

Benefits

UT SELECT medical insurance is offered free for employees; family members may be added through payroll deduction.
Discounted copays and coinsurance when employees and dependents use UT Health Physicians.
$50,000 of group term life insurance and $50,000 of basic accidental death and dismemberment insurance at no cost, with options to purchase additional coverage.
Three dental plan options through Delta Dental: two PPO plans and one HMO plan.
Two vision plan options through Superior Vision Services.
Optional disability insurance providing income if a non-work-related illness or injury prevents work.
Flexible spending accounts for qualifying dependent day care or out-of-pocket health care expenses.
Eligibility for either the Teacher Retirement System or Optional Retirement Plan, plus voluntary retirement programs.
Front-loaded paid time off of 128 to 208 hours (16 to 26 days) annually, based on years of service; prorated in the first year may apply.
Extended Illness Bank accrual of 8 hours per month.
Up to 240 hours (6 weeks) of paid family leave after six months of consecutive employment.
12 paid holidays each year.
Discounts on services, tickets, and gym membership.