Insurance Follow up Rep II - Kelsey Seybold Clinic - Pearland

Improve the lives of others while Caring. Connecting. Growing together.

Job Description
- Insurance Follow up Rep II
- Kelsey Seybold Clinic
- Pearland (2385054)

Insurance Follow up Rep II
- Kelsey Seybold Clinic
- Pearland - 2385054

Explore opportunities with Kelsey-Seybold Clinic, part of the Optum family of businesses. Work with one of the nation’s leading health care organizations and build your career at one of our 40+ locations throughout Houston. Be part of a team that is nationally recognized for delivering coordinated and accountable care. As a multi-specialty clinic, we offer care from more than 900 medical providers in 65 medical specialties.

Take on a rewarding opportunity to help drive higher quality, higher patient satisfaction and lower total costs. Join us and discover the meaning behind Caring. Connecting. Growing together.

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. The Representative is responsible for an inventory of over a $1M in insurance receivables.

They will initiate contacts and negotiate appropriate resolution (internal and external) as well as receive and resolve inquiries and correspondence from third parties and patients. The ability to analyze, audit, problem solve and reconcile an account is critical to this position. This position conducts duties in accordance with industry federal and state billing guidelines and contractual obligations and in compliance with department policies and procedures.

Must 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.

• 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
• The Representative is responsible for an inventory of over a $1M in insurance receivables
• They will initiate contacts and negotiate appropriate resolution (internal and external) as well as receive and resolve inquiries and correspondence from third parties and patients
• The ability to analyze, audit, problem solve and reconcile an account is critical to this position
• This position conducts duties in accordance with industry federal and state billing guidelines and contractual obligations and in compliance with department policies and procedures
• Must 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
• Professionalis…