UHG

About UHG

Careers at UnitedHealth Group

 

We have modest goals: Improve the lives of others. Change the landscape of health care forever. Leave the world a better place than we found it. Such aspirations tend to attract a certain type of person. Crazy talented. Compassionate. Driven. To these individuals, we offer the global reach, resources and can-do culture of a Fortune 5 company. We provide an environment where you’re empowered to be your best. We encourage you to take risks and in return, offer a world of rewards and benefits for performance. Exceeding your limits is an exceptional start to your life's best work.SM

 

Just like you, we are driven by a set of fundamental principles that are guiding our way forward. Our values of integrity, compassion, relationships, innovation, and performance serve as a foundation to transform health care. Are you in? Learn more about your future at UnitedHealth Group at careers.unitedhealthgroup.com

 

Job Category:

Accounting/Finance

Country:

US

Approximate Salary:

Not Specified

Position Type:

Full Time

Senior Medical Biller - San Antonio, TX

UHG - San Antonio, Texas

Posted: 12/13/2018

The Biller / Collector II 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 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 (Biller)
  • 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 (Collector)
  • 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 (Payment Poster)
  • 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 duties as assigned

Required Qualifications:
  • High school diploma or GED equivalent
  • 4 - 5 years of relevant medical experience
  • Strong attention to detail and professional customer service skills
  • Proficiency with Microsoft Office applications 
Preferred Qualifications:
  • Medical terminology and ICD / CPT coding
  • Technical skills in the areas of EDI, systems analysis and process flows
  • 2+ years of related billing and / or collection experience
  • Coding certification
  • 50 wpm typing skill
  • 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 HIPPA compliance rules and regulations
  • 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 detail
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 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: Senior Medical Biller, San Antonio, TX, Texas

Apply Now