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Hybrid Insurance Follow Up Specialist

at Margie and Bill Klesse College of Engineering and Integrated Design at UTSA
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Posted last month

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About the role

  • Initiates insurance follow up on unresolved appealed or unpaid claims, to ensure maximum and timely reimbursement for Medicare, Medicaid, Commercial, or Specialty insurance/program payors.
  • Submits appeals and reconsiderations on claim denials via practice management system, payor portals, or mail.
  • Analyze daily claim rejections from our clearing house, screen claims for pre-authorization, request and submit medical records.
  • Work closely with the Coding, Payment Posting, Managed Care Operations, Provider Enrollment, and Clinical Operations to resolve claim issues.
  • Review and respond to insurance correspondence letters related to recoupments, refunds, eligibility or additional requests from payors
  • Assist customer service team in resolving patient billing concerns or disputes.
  • Verify patient benefits and insurance eligibility, perform claims status verification, navigate through insurance websites for specific payor guidelines, and effectively communicate findings to insurance companies, management team, and clinical departments.
  • Completes all other duties as assigned.

Requirements

  • Three (3) years hospital business office or medical billing related experience
  • HS Diploma or Equivalent

Benefits

  • Some knowledge of patient billing or collection/reimbursement procedures in a healthcare setting preferred. Experience in medical claims follow-up functions specific to processing insurance claim appeals for various payors.
  • Detail oriented with the ability to organize, prioritize and coordiante work within schedule constraints and handle emergent requirements in a tiemly manner.
  • Ability to multi-task in a fast paced, high-volume environment.
  • Proficient in Microsoft Office.
  • EPIC experience.
  • Experian, Trizetto/Claim Logic.

Job title

Insurance Follow Up Specialist

Job type

Full Time

Experience level

Mid levelSenior

Salary

Not specified

Degree requirement

High School Diploma

Location requirements

HybridSan AntonioUnited States

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