Optum
Insurance Follow-Up Representative II-Kelsey Seybold Clinic-Pearland Administrat
Optum, Pearland, Texas, United States, 77581
Insurance Follow-Up Representative
Under the supervision of the Business Office Supervisor, 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. Primary Responsibilities: Responsible for an inventory of over a $1M in insurance receivables Initiate contacts and negotiate appropriate resolution (internal and external) as well as receive and resolve inquiries and correspondence from third parties and patients 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 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 Required Qualifications: High School diploma or GED from an accredited program 3+ years of current experience in a health care billing and collection environment or relevant health care setting using an accounting/health care computer system or two years of related experience with preferred education Demonstrated basic PC and Internet literacy Medical Terminology, CPT & ICD coding application experience Experience with interpreting Explanation of Benefits (EOB's), physician billing statements Proven good analytical and mathematical ability Proven excellent interpersonal communications skills and ability to communicate effectively both orally and in writing with patients, physicians, management, and third-party representatives Ability to handle a variety of tasks with speed, attention to detail and accuracy Proven working knowledge of major third-party payers and their websites Preferred Qualifications: Associate's degree in business administration or related field; or successful completion of Coding and Billing Certificate Program 5+ 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 Proven understanding of a diversity of insurance plans Epic Professional Billing experience Ability to access and retrieve information from the EHR 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 $17.74 to $31.63 per hour based on full-time employment. We comply with all minimum wage laws as applicable.
Under the supervision of the Business Office Supervisor, 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. Primary Responsibilities: Responsible for an inventory of over a $1M in insurance receivables Initiate contacts and negotiate appropriate resolution (internal and external) as well as receive and resolve inquiries and correspondence from third parties and patients 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 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 Required Qualifications: High School diploma or GED from an accredited program 3+ years of current experience in a health care billing and collection environment or relevant health care setting using an accounting/health care computer system or two years of related experience with preferred education Demonstrated basic PC and Internet literacy Medical Terminology, CPT & ICD coding application experience Experience with interpreting Explanation of Benefits (EOB's), physician billing statements Proven good analytical and mathematical ability Proven excellent interpersonal communications skills and ability to communicate effectively both orally and in writing with patients, physicians, management, and third-party representatives Ability to handle a variety of tasks with speed, attention to detail and accuracy Proven working knowledge of major third-party payers and their websites Preferred Qualifications: Associate's degree in business administration or related field; or successful completion of Coding and Billing Certificate Program 5+ 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 Proven understanding of a diversity of insurance plans Epic Professional Billing experience Ability to access and retrieve information from the EHR 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 $17.74 to $31.63 per hour based on full-time employment. We comply with all minimum wage laws as applicable.