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Insurance Follow-Up Representative II

Company: Kelsey Seybold Clinic
Location: Pearland
Posted on: May 3, 2021

Job Description:

Overview

Insurance Follow-Up Rep II

Location: Pearland Administrative OfficeJob Type: Full Time

Department: Finance/ Business Office

COMPANY PROFILE

Kelsey-Seybold Clinic. Changing the way health cares.Kelsey-Seybold Clinic is Houston's premier multispecialty group practice, founded in 1949 by Dr. Mavis Kelsey. With 19 clinic locations and more than 400 physicians, Kelsey-Seybold provides medical care in 55 medical specialties and is home to a nationally accredited Breast Diagnostic Center, Endoscopy Center, Infusion Center and Cancer Center. Our mission is to provide our team members with exceptional opportunities for professional and personal growth.

JOB SUMMARY

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. 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.

EDUCATION REQUIREMENTS & EXPERIENCE REQUIREMENTS

(A = basics; B = preferred)

Education

A.

High School diploma or GED from an accredited program

B.

Associates degree in Business Administration or related field; or successful completion of Coding and Billing Certificate Program.

Experience

A.

Requires 3 or more years experience in a health care billing and collection environment or relevant health care setting using an accounting/health care computer system; or 2 year of related experience with preferred education.

B.

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.

Licenses

A.

B.

Special Skills

A.

Basic PC and Internet literacy. Medical Terminology, CPT & ICD coding application. Interpreting Explanation of Benefits (EOB's), physician billing statements. Good analytical and mathematical ability.

B.

Epic Professional Billing. Ability to access and retrieve information from the EHR.

Other

A.

Excellent interpersonal communications skills and ability to communicate effectively both orally and in writing with patients, physicians, management, and third-party representatives. Ability to handle a variety of tasks with speed, attention to detail and accuracy. Working knowledge of major third-party payers and their websites.

B.

WORKING ENVIRONMENT

Office

Keywords: Kelsey Seybold Clinic, Pearland , Insurance Follow-Up Representative II, Other , Pearland, Texas

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