Insurance Follow-Up Representative III - Kelsey Seybold Clinic - Pearland - Hybrid

Primary Responsibilities

• Ensures the efficient operation and effective reimbursement of third party account receivables by researching accounts, refilling or appealing claims, submitting additional medical documentation and tracking account status
• Researches and analyzes an aged trail balance representing over a million dollars in insurance receivables
• Initiates contacts and negotiates appropriate resolution (internal and external) as well as receives and resolves inquiries and correspondence from third parties and patients
• Analyzes, audits, and reconciles an account is critical to this position
• Conducts duties in accordance with industry federal and state billing and contractual obligations and in compliance with department policies and procedures
• Demonstrate dependability and an ability to work independently
• Able to retain composure, meet deadlines, and appropriately analyze, research, and resolve problems in a stressful environment with constant work-related interruptions
• Analyze and resolve aged accounts and provide feedback to the supervisor for auditing and training of junior follow-up representatives
• Professionalism and courtesy when communicating with patients and other external contacts, primarily by telephone, displaying an attitude of proven, committed customer service

Required Qualifications

• 4+ years of experience in a health care billing and collection environment or relevant health care setting using an accounting/health care computer system
• Basic PC literacy Alpha/num forms entry experience
• Medical Terminology, CPT & ICD coding experience
• Experience interpreting Explanation of Benefits (EOB's), physician billing system
• Proven detailed knowledge of healthcare insurance

Preferred Qualifications

• Successful completion of Coding and Billing class
• 6+ 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
• IDX or Epic Professional Billing experience
• Proven understanding of a diversity of insurance plans
• Lead analyst or coordinator experience
• Appeals experience (claims denials), Epic Professional Billing experience
• Proven good analytical and mathematical ability skills

Pay and Benefits

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements).

The hourly pay for this role will range from $20.00 to $36.00 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission

OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.