Collections Representative - Kelsey Seybold Clinic - Pearland

Posted Yesterday
Be an Early Applicant
Pearland, TX, USA
In-Office
18-32 Hourly
Mid level
Artificial Intelligence • Big Data • Healthtech • Information Technology • Machine Learning • Software • Analytics
The Role
Handles inbound patient calls, financial clearance, outstanding balance collection, payment arrangements, account analysis, appeals, and insurance benefit interpretation. Explains financial responsibilities and payment options while maintaining professional patient communication, meeting production and quality standards, and following healthcare billing policies. The role requires healthcare collections expertise, knowledge of insurance rules, medical terminology, CPT and ICD coding, EOB interpretation, and physician billing systems experience.
Summary Generated by Built In
Requisition Number: 2386275
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.
Primary Responsibilities:
  • The Collections Representative is responsible for answering inbound calls and screening patients for financial clearance, collecting outstanding balances, reducing bad debt and arranging payment plans
  • This position assists in notifying patients who have previous balances of their financial responsibility and helping them understand their payment options
  • Other duties include performing financial collection functions, (e.g., account analysis, extended payment arrangements)
  • Maintains effective communication and professional interaction with patients and fellow co-workers
  • Conducts duties in accordance with industry standards and in compliance with department policy & procedure
  • Must be able to meet Central Business Office standards for established production and quality standards

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
  • High school diploma or GED
  • 3+ years of healthcare collections (both self-pay and insurance) with guarantor account follow-up, successful appeals outcomes and the ability to interpret plan benefits/payment methodology by primary and secondary health plans
  • Basic PC Literacy. Alpha/Num Forms Entry. Medical Terminology, CPT & ICD coding experience. Use of physician billing systems and interpretation of Explanation of Benefits (EOB's)
  • Detailed knowledge of healthcare insurance to include diversified understanding of rules and regulations of Commercial Insurance with appeals experience (claims denials)
  • Analytical skills to include interpretation of guarantor account balances with problem resolution. Excellent telephone etiquette with demonstrated capability to meet with patients one-on-one and explain payment methodology by the insurance carrier.
  • Ability to work independently and display teamwork qualities among peers and other department personnel

Preferred Qualifications:
  • Successful completion of Medical Billing & Coding class
  • Certified/Licensed Medical Billing
  • 1+ years of KSC Epic practice management system experience
  • Proficiency in Microsoft Word and Excel
  • Ability to handle a variety of tasks with speed and attention to detail

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $18.00 to $32.00 per hour based on full-time employment. We comply with all minimum wage laws as applicable.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

Skills Required

  • High school diploma or GED
  • At least 3 years of healthcare collections experience, including self-pay and insurance collections
  • Guarantor account follow-up experience and successful appeals outcomes
  • Ability to interpret plan benefits and payment methodology for primary and secondary health plans
  • Basic PC literacy and alphanumeric form entry
  • Medical terminology, CPT, and ICD coding experience
  • Experience using physician billing systems and interpreting Explanation of Benefits statements
  • Detailed knowledge of commercial insurance rules, regulations, and claims-denial appeals
  • Analytical problem-solving skills for interpreting guarantor account balances
  • Excellent telephone etiquette and ability to explain insurance payment methodology to patients
  • Ability to work independently and collaboratively with coworkers and department personnel
  • Successful completion of a medical billing and coding class
  • Certified or licensed medical billing qualification
  • At least 1 year of experience with the KSC Epic practice management system
  • Proficiency in Microsoft Word and Excel
  • Ability to handle varied tasks with speed and attention to detail

What the Team is Saying

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The Company
HQ: Eden Prairie, MN
160,000 Employees
Year Founded: 2011

What We Do

Optum, part of the UnitedHealth Group family of businesses, is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. At Optum, we support your well-being with an understanding team, extensive benefits and rewarding opportunities. By joining us, you’ll have the resources to drive system transformation while we help you take care of your future. We recognize the power of connection to drive change, improve efficiency and make a difference in health care. Join a team where your skills and ideas can make an impact and where collaboration is key to creating technology that produces healthier outcomes.

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Optum Offices

Hybrid Workspace

Employees engage in a combination of remote and on-site work.

Optum has three workplace models that balance the needs of the business and the responsibilities of each role. These models, core on‑site (5 days/week), hybrid (4 days/week) and telecommute or fully remote, vary by country, role and location.

Typical time on-site: Not Specified
HQEden Prairie, MN
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