Under general supervision, responsible for performing routine calculating, posting, and verifying duties to obtain primary insurance data for preparing statements to patients' insurance carriers. Prepares notices to patients regarding amounts expected or received from insurance and amounts expected from the patient.
Reviews claims adjudicated by Medicare, Medicaid, and Commercial carriers for appropriate billing. Addresses denied claims, claims pended for medical necessity, and claims pending supporting documentation or medical records by collaborating with clinic staff, registration staff, and coding staff to complete appeals.
Extracts information from medical records and works closely with coding staff to compose individualized appeal letters. Identifies payor-specific patterns or trends regarding denials and reports to management for communication to medical departments and administrators. Makes recommendations regarding billing and edit creation to reduce denials.
Utilizes collection processes such as appeals, collection notices by mail, electronic correspondence, and telephone communication with payor representatives. Remains current in all payor-specific guidelines.
Benefits include medical, dental, vision insurance, disability insurance, flexible spending accounts, retirement plans, paid time off, paid family leave, holidays, and employee discounts.
The position requires detail orientation, ability to prioritize and coordinate work, monitor complex projects, proficiency in Microsoft Office and email software, effective communication skills, and customer service excellence.
Detail oriented with ability to organize, prioritize, and coordinate work within schedule constraints and handle emergent requirements timely. Ability to monitor important and complex projects concurrently. Knowledge of Microsoft Word, Excel, PowerPoint, Lotus Notes or other email software. Effective oral and written communication skills, including writing memos, letters, and other official correspondence. Ability to maintain security and integrity per Texas EO-GA-48. Experience with reviewing insurance claims, addressing denials, medical necessity documentation, and working with clinical and coding teams for appeals. Current knowledge of payor-specific guidelines and billing processes.
Medical insurance (UT SELECT) free for employees, family coverage via payroll deduction, discounted copays with network physicians. Dental insurance with multiple plan options. Vision insurance with standard and enhanced plans. Disability insurance providing income during non-work related illness or injury. Flexible spending accounts for dependent care and healthcare expenses. Retirement options including Teacher Retirement System (TRS) and Optional Retirement Plan (ORP) with employer matching. Generous paid time off program including front-loaded PTO, extended illness bank, paid family leave, and holidays. Range of employee discounts on services, tickets, and gym memberships.
Location
San Antonio, Texas, US
Employment Type
Full-time
Experience Level
Intermediate Level
Remote work allowed
No
Posted
3 weeks ago