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Senior Medical Biller - San Antonio, TX

UnitedHealth Group

San Antonio, TX
Job Code:
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Job Details

Senior Medical Biller - San Antonio, TX(Job Number:719185)

The Biller / Collector II is an Accounts Receivable function. To perform this job successfully, an individual should 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, coding for medical diagnosis and procedural coding. Individual must be familiar with the conventions and instructions provided within the ICD disease classifications and CPT coding guidelines. Should 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.


Additionally, this position may be responsible for any or all of the following: acting as a resource to other staff and clinics, timely billing or filing of claims for services rendered at the clinics, reviewing claims that are rejected / denied / not paid for errors or incorrect filing with the Carriers and Medicare, billing patients and collecting for fees deemed to be the patient’s responsibility, billing secondary insurance, data entry of encounter data (or fee tickets) from the Clinics, and Evaluation and Management Documentation Guidelines.


Primary Responsibilities:

  • Review 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 (Biller)

  • 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 apply correctly to claims / fee billed (Collector)

  • 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 (Payment Poster)

  • Responsible for reviewing insurance payer reimbursements for correct contractual allowable amounts

  • Responsible for reporting payer payment and denial trends in a timely fashion

  • 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

  • Able to prepare documents for training or for establishing procedures for clinics

  • Identifies problems and root cause of problems related to billing and collections

  • Assist with training materials and training staff members

  • Responsible for identifying problems / trends in medical documentation and reporting them in a timely fashion

  • Answers patient and customer questions regarding billing and statements

  • Prepare claims for encounters with complex progress note issues

  • Participates with special assigned projects

  • Performs all other duties as assigned

Job Collections
Primary Location US-TX-San Antonio
Other Location 
Organization WellMed Medical Mgmt, Inc
Schedule Full-time
Number of Openings 1
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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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