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Medical Billing Representative - San Antonio, TX

UnitedHealth Group

San Antonio, TX
Job Code:
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Job Details

748829 Medical Billing Representative San Antonio TX

Medical Billing Representative - San Antonio, TX (748829)

Position Description

It takes a special person to be effective in stressful situations. In fact, it takes a gifted, diplomatic and persistent person who can see past the challenge to a successful outcome. If that’s you, get with us because this role at UnitedHealth Group is all about special. You'll consult directly with our customers who have outstanding medical bills to identify reasons for late payments and set up payment plans that are mutually agreeable. It’s an important role and it will take all of your skills. Join us and discover the exceptional training, support and opportunities to grow that you'd expect from a Fortune 6 leader.
The Biller/Collector position is an Accounts Receivable function.  To perform this job successfully, an individual must 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 and coding for medical diagnosis and procedural coding. Individual should be familiar with the conventions and instructions provided within the ICD disease classifications and CPT coding guidelines. Should also 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.
    Primary Responsibilities:
    • Reviews 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
    • 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 correctly to claims/ fee billed
    • 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
    • Responsible for reviewing insurance payer reimbursements for correct contractual allowable amounts
    • 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
    • Prepare documents for training or for establishing procedures for clinics
    • Answer patient and customer questions regarding billing and statements
    • Performs all other related duties as assigned
This is a challenging role that requires providing best in class service to our customers during their times of difficulty. It’s a fast paced environment that requires focus and ability to multi-task throughout the day. This is a 40 hour, full time role working flexible shifts, sometimes including evenings or Saturdays. We require our employees to be flexible enough to work any shift, any day of the week during those hours.

Required Qualifications:

  • High school diploma or GED equivalent
  • Two or more years of relevant experience in the healthcare industry, with a focus on medical terminology and ICD/CPT coding preferred
  • Strong attention to detail and professional customer service skills
  • At least an intermediate level with Microsoft Office applications
  • At least an intermediate level of data entry


Preferred Qualifications:

  • Technical skills in the areas of EDI, systems analysis and process flows
  • Coding certification
  • 50wpm 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 HIPAA 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: San Antonio, Texas, TX, Billing, collections, clerical, support, clerk

Job Details

  • Contest Number748829
  • Job TitleMedical Billing Representative - San Antonio, TX
  • Job FamilyBilling
  • Business SegmentOptumCare

Job Location Information

  • San Antonio, TX
    United States
    North America

Additional Job Detail Information

  • Employee StatusRegular
  • ScheduleFull-time
  • Job LevelIndividual Contributor
  • ShiftDay Job
  • TravelNo
  • Telecommuter PositionNo
  • Overtime StatusNon-exempt

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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