Insurance Follow-Up Rep II
Location: Pearland Administrative Office
Job Type: Full-Time
Department: Bus Ofc - Insurance Follow-Up
Kelsey-Seybold Clinic. Your Doctors for Life.
Since 1949, Kelsey-Seybold Clinic has served its patients with one goal in mind – combine the expertise of physicians in a variety of medical specialties, with the close personal care of a family doctor. Kelsey-Seybold is Houston’s largest community-based physician group, caring for more than 400,000 patients. With 19 clinic locations, we are growing to meet the health care needs of our diverse patient population. Our mission is to provide our team members with exceptional opportunities for professional and personal growth.
Under the supervision of the Business Office Supervisor ensures the efficient operation and effective reimbursement of third party account receivables by researching accounts, refiling or appealing claims, submitting additional medical documentation and tracking account status by monitoring and analyzing assigned unresolved third party accounts. These representatives are responsible for an aged trail balance representing over a million dollars 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 and reconcile 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. 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 stressful environment with constant work-related interruptions. Professionalism and courtesy when communicating with patients and other external contacts, primarily by telephone, displaying an attitude of proven, committed customer service as well.
EDUCATION REQUIREMENTS & EXPERIENCE REQUIREMENTS
(A = basics; B = preferred)
Associates degree in Business Administration or related field. Additional experience may be substituted for required degree on a one-for-one basis.
Bachelor’s degree in Business Administration or related field. Successful completion of Coding and Billing class.
Requires 2 or more years experience in a health care billing and collection environment or relevant health care setting using an accounting/health care computer system. One year of related experience with preferred degree.
5 years 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 a definite plus as is an understanding of a diversity of insurance plans.
Basic PC Literacy. Alpha/Num Forms Entry. Medical Terminology, CPT & ICD coding experience. Interpreting Explanation of Benefits (EOB’s), physician billing system.
Appeals experience (claims denials), IDX or Epic Professional Billing. Good analytical and mathematical ability
Excellent interpersonal communications skills and strong written and verbal communications skills for staff and patient interaction.
Working knowledge of major third party payers. Ability to handle a variety of tasks with speed, attention to detail and accuracy.