Sr. Billing Rep - San Antonio, TX
Company: UnitedHealth Group
Location: San Antonio
Posted on: May 16, 2022
Job Description:
Do you have compassion and a passion to help others?
Transforming healthcare and millions of lives as a result starts
with the values you embrace and the passion you bring to achieve
your life's best work.(sm)The Biller/Collector II position is an
Accounts Receivable function. -To perform this job successfully, an
individual should 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, coding for
medical diagnosis and procedural coding. Individual must 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.Additionally, this position may be responsible for
any or all of the following acting as a resource to other staff and
clinics: timely billing or filing of claims for services rendered
at the clinics; reviewing claims that are rejected/denied/not paid
for errors or incorrect filing with the Carriers and Medicare;
billing patients and collecting for fees deemed to be the patient's
responsibility; billing secondary insurance; data entry of
encounter data (or fee tickets) from the Clinics; and Evaluation
and Management Documentation Guidelines.Primary
REsponsibilities:
- Review medical record documentation to identify services
provided by physicians and mid-level providers as it pertains to
claims that are being filed
- Verifies appropriate CPT, ICD, and HCPCS codes to accurately
file claims for the physician service using the medical record as
supporting documentation
- Performs corrections for patient registration information that
includes, but is not limited to, patient demographics and insurance
information
- Responsible for working EDI claim rejections in a timely
manner
- Receives and interprets Explanation of Benefits (EOB) that
supports payments from Insurance Carriers, Medicare, or patients.
-Able to apply correctly to claims/ fee billed. -
- Processes 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
insurance
- Responsible for processing payments, adjustments and denials
according to established guidelines
- Responsible for reviewing insurance payer reimbursements for
correct contractual allowable amounts
- Responsible for reporting payer payment and denial trends in a
timely fashion
- Responsible for reconciling transactions to ensure that
payments are balanced
- Responsible for reducing accounts receivables by accurately and
thoroughly working assigned accounts in accordance with established
policy and procedures
- Responsible for keeping current with changes in their
respective payer's policies and procedures
- Communicates with the Clinics to provide or obtain corrected or
additional data
- Able to prepare documents for training or for establishing
procedures for clinics
- Identifies problems and root cause of problems related to
billing and collections
- Assist with training materials and training staff members
- Responsible for identifying problems/trends in medical
documentation and reporting them in a timely fashion
- Answers patient and customer questions regarding billing and
statements
- Prepare claims for encounters with complex progress note
issues
- Participates with special assigned projects
- Performs all other related duties as assignedYou'll be rewarded
and recognized for your performance in an environment that will
challenge you and give you clear direction on what it takes to
succeed in your role as well as provide development for other roles
you may be interested in.Required Qualifications:
- Technical skills in the areas of EDI, systems analysis and
process flows
- 2+ -years of related billing and/or collection experience
required
- Knowledge of submission and resubmission of medical
claims.
- Knowledge of government and commercial policies and
procedures.
- Knowledge of ICD, CPT codes and HCPCS coding.
- Knowledge of HIPAA compliance rules and regulations.
- Full COVID-19 vaccination is an essential requirement of this
role. UnitedHealth Group will adhere to all -federal, state and
local regulations as well as all client requirements and will
obtain necessary proof of vaccination prior to employment to ensure
compliancePreferred Qualifications:
- Coding certification -
- 50wpm typing skill -
- Skill in the operation of billing software and office
equipment.
- Skill in using Microsoft Office (Outlook, Excel, Word)
- Skill in processing claims efficiently and on a timely
basis
- Solid customer service skills and excellent interpersonal
skills
- Attention to detailTo protect the health and safety of our
workforce, patients and communities we serve, UnitedHealth Group
and its affiliate companies now require all employees to disclose
COVID-19 vaccination status prior to beginning employment. In
addition, some roles require full COVID-19 vaccination as an
essential job function. UnitedHealth Group adheres to all federal,
state and local COVID-19 vaccination regulations as well as all
client COVID-19 vaccination requirements and will obtain the
necessary information from candidates prior to employment to ensure
compliance. Candidates must be able to perform all essential job
functions with or without reasonable accommodation. Failure to meet
the vaccination requirement may result in rescission of an
employment offer or termination of employment. -Careers 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 550,000+ 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:
OptumCare is an Equal Employment Opportunity/Affirmative Action
employers 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.OptumCare is a drug-free workplace. Candidates are required to
pass a drug test before beginning employmentJob Keywords: Biller,
Billing, San Antonio, TX
Keywords: UnitedHealth Group, San Antonio , Sr. Billing Rep - San Antonio, TX, Accounting, Auditing , San Antonio, Texas
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