It takes a special person to be effective in stressful situations. In fact, it takes a gifted, diplomatic and persistent person who can see past the challenge to a successful outcome. If that's you, get with us because this role at UnitedHealth Group is all about special. You'll consult directly with our customers who have outstanding medical bills to identify reasons for late payments and set up payment plans that are mutually agreeable. It's an important role and it will take all of your skills. Join us and discover the exceptional training, support and opportunities to grow that you'd expect from a Fortune 6 leader. The Biller/Collector position is an Accounts Receivable function. To perform this job successfully, an individual must be able to perform each assigned essential duty satisfactorily. This position is expected to have excellent reasoning skills based on knowledge of clinic operations as it pertains to billing claims to Insurance Health Plans and coding for medical diagnosis and procedural coding. Individual should be familiar with the conventions and instructions provided within the ICD disease classifications and CPT coding guidelines. Should also be able to reason through insurance claims differences as defined by benefit and plan differences. This position is responsible for resolution of A/R in a complete, accurate, and timely manner while verifying that industry rules and regulations, including, local, state, and federal regulations, regarding billing and collection practices are followed; as well as with established internal policy and procedure. Primary Responsibilities:Reviews medical record documentation to identify services provided by physicians and mid-level providers as it pertains to claims that are being filedVerifies appropriate CPT, ICD, and HCPCS codes to accurately file claims for the physician service using the medical record as supporting documentationPerforms corrections for patient registration information that includes, but is not limited to, patient demographics and insurance informationResponsible for working EDI claim rejections in a timely mannerReceives and interprets Explanation of Benefits (EOB) that supports payments from Insurance Carriers, Medicare, or patients. Able to apply correctly to claims/ fee billedProcesses incoming EOBs to ensure timely insurance filing or patient billing. May require correction of data originally submitted for a claim or Coordination of Benefits with secondary insuranceResponsible for processing payments, adjustments and denials according to established guidelinesResponsible for reviewing insurance payer reimbursements for correct contractual allowable amountsResponsible for reconciling transactions to ensure that payments are balancedResponsible for reducing accounts receivables by accurately and thoroughly working assigned accounts in accordance with established policy and proceduresResponsible for keeping current with changes in their respective payer's policies and proceduresCommunicates with the Clinics to provide or obtain corrected or additional dataPrepare documents for training or for establishing procedures for clinicsAnswer patient and customer questions regarding billing and statementsPerforms all other related duties as assignedThis is a challenging role that requires providing best in class service to our customers during their times of difficulty. It's a fast paced environment that requires focus and ability to multi-task throughout the day. This is a 40 hour, full time role working flexible shifts, sometimes including evenings or Saturdays. We require our employees to be flexible enough to work any shift, any day of the week during those hours.
High school diploma or GED equivalent Two or more years of relevant experience in the healthcare industry, with a focus on medical terminology and ICD/CPT coding preferredStrong attention to detail and professional customer service skillsAt least an intermediate level with Microsoft Office applications At least an intermediate level of data entryPreferred Qualifications:Technical skills in the areas of EDI, systems analysis and process flowsCoding certification 50wpm typing skill Knowledge of submission and resubmission of medical claimsKnowledge of government and commercial policies and proceduresKnowledge of ICD, CPT codes and HCPCS codingKnowledge of HIPAA compliance rules and regulationsSkill in the operation of billing software and office equipmentSkill in using Microsoft Office (Outlook, Excel, Word)Skill in processing claims efficiently and on a timely basisSolid customer service skills and excellent interpersonal skillsAttention to detailCareers with WellMed. Our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. We're impacting 90,000+ lives, primarily Medicare eligible seniors in Texas and Florida, through primary and multi-specialty clinics, and contracted medical management services. We've joined Optum, part of the UnitedHealth Group family of companies, and our mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness. Our providers and staff are selected for their dedication and focus on preventative, proactive care. For you, that means one incredible team and a singular opportunity to do your life's best work.(sm)Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. Job Keywords: San Antonio, Texas, TX, Billing, collections, clerical, support, clerk,
Our mission is to help people live healthier lives and to help make the health system work better for everyone.- We seek to enhance the performance of the health system and improve the overall health and well-being of the people we serve and their communities. - We work with health care professionals and other key partners to expand access to quality health care so people get the care they need... at an affordable price. - We support the physician/patient relationship and empower people with the information, guidance and tools they need to make personal health choices and decisions.