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Full-time
high school
Medical insurance, Life insurance, Accidental death and dismemberment insurance, Dental insurance, Vision insurance, Disability insurance
Posted 1d ago
Apply by Oct 10
~40 hrs/week
Responsibilities
The Senior Insurance Follow-up Specialist manages complex insurance claims, processes appeals, and resolves billing disputes to ensure timely reimbursement. They also mentor team members, streamline workflows, and serve as a liaison between departments and insurance payors.
Requirements
Candidates should have experience in medical claims follow-up, insurance appeals, and patient billing procedures within a healthcare setting. Proficiency in Microsoft Office and medical records software is required, along with a high school diploma.
Full job description
The Insurance Follow-up Specialist- Senior completes follow-up activities on outstanding insurance medical claims for Medicare, Medicaid, Commercial, and Specialty insurance/program payors for a subset of multiple specialties. Analyze, screen, and update high complexity or escalated claim issues. Process appeals, write-offs, and determine if patient billing is necessary. May mentor newer team members.
Responsibilities
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, with a focus on complex insurance denials.
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 teams, and clinical departments.
Assist the customer service team in resolving high-complexity and/or escalated patient billing concerns or disputes.
Review and respond to insurance correspondence letters related to recoupments, refunds, eligibility, or additional requests from payors.
Analyze daily claim rejections, screen claims for pre-authorization, and request and submit medical records.
Work closely with the team to manage high-complexity work queues and claims. Lead special projects to fruition and help define and streamline workflows.
Meet or exceed current production standards set by the management team to resolve outstanding claims and maintain healthy accounts receivable.
Handle requests from the Coding, Payment Posting, Managed Care Operations, Provider Enrollment, and Clinical Operations Team to resolve claims and patient or provider issues.
Serve as the liaison between affiliated hospitals and organizations to maximize collection efforts.
Completes all other duties as assigned.
Qualifications
Knowledge of patient billing or collection/reimbursement procedures in a healthcare setting is 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 coordinate work within schedule constraints and handle emergent requirements in a timely manner.
Able to multi-task in a fast-paced, high-volume environment.
Proficient in Microsoft Office software.
Medical healthcare records software experience.
Experian, Trizetto/Claim Logic experience.
Education:
High School Diploma required
The University of Texas at San Antonio (UT San Antonio) is a nationally recognized, top-tier public research university that unites the power of higher education, biomedical discovery and healthcare within one visionary institution. As the third-largest research university in Texas and a Carnegie R1-designated institution, UT San Antonio is a model of access and excellence — advancing knowledge, social mobility and public health across South Texas and beyond. UT San Antonio serves approximately 42,000 students in 320 academic programs spanning science, engineering, medicine, health, liberal arts, AI, cybersecurity, business, education and more. With 17,000 faculty and staff, UT San Antonio has been recognized by Forbes as one of America’s Best Employers for Company Culture.
Benefits Overview
UT Health San Antonio offers an excellent benefits package for its employees. Employees who work at least 20 hours a week, with an appointment of at least 4.5 months, are eligible for benefits.
Medical - UT SELECT Medical insurance is offered free for employees and administered by Blue Cross and Blue Shield of Texas. Family members can be added to the plan through payroll deduction. Employees and their dependents can also receive discounted copays and coinsurance when using UT Health Physicians, a network of 800 premier physicians including more than 100 specialists. Employees receive $50,000 of group term life insurance and $50,000 of basic accidental death and dismemberment insurance for free, with options to purchase additional employee and dependent coverage for both at group rates.
Dental - Three dental insurance plan options are available for employees and their families through Delta Dental Insurance Company, two PPOs and one dental HMO plan. Both PPO plans allow employees to choose any licensed dentist.
Vision - Fully insured Vision Care benefits are offered by Superior Vision Services. Two vision plan options that offer either standard or enhanced vision benefits.
Disability - Employees can enroll in the Disability Insurance which provides income if a non-work related illness or injury prevents you from working.
FSAs - Employees can enroll in flexible spending accounts (FSAs) to set aside money from earnings before taxes for qualifying dependent day care expenses or out-of-pocket health care expenses.
Retirement - Employees are eligible for either the Teacher Retirement System (TRS) or the Optional Retirement Plan (ORP). TRS is a defined benefit retirement plan which UT Health matches employee contributions. ORP is for eligible faculty staff employees. Voluntary retirement programs are also available to invest before- or after-tax dollars with the choice of five quality retirement plan providers.
Time Off - A generous leave program offers multiple paid leave options:
Front-loaded Paid Time Off: 128 to 208 hours (16 to 26 days) of Paid Time Off based on years of service, given at the start of each fiscal year. PTO may be prorated in year one based on date of hire.
Extended Illness Bank: 8 hours (1 day) accrued per month which can be used for illness or injury after one day of Paid Time Off is taken.
Paid Family Leave: Up to 240 hours (6 weeks) to care for a spouse, child, or parent after 6 months of consecutive employment.
Holidays: 12 set paid holidays each year.
Discounts - Employees enjoy a range of discounts on services, tickets, and gym membership.
EEO Statement
UT Health San Antonio is an equal employment opportunity and affirmative action employer. It is our policy to promote and ensure equal employment opportunity for all individuals without regard to race, color, religion, sex, gender identity, national origin, age, sexual orientation, disability, or veteran status.
Since 2004, UT Health San Antonio, Greehey Children’s Cancer Research Institute’s (GCCRI) mission has been to advance scientific knowledge relevant to childhood cancer, contribute to the understanding of causes of childhood cancer, and accelerate the translation of knowledge into novel therapies. Through discovery, development, and dissemination of new scientific knowledge, GCCRI strives to have a national and global impact on the problem of childhood cancer. Our mission consists of three key areas — research, clinical and education.
RESEARCH: Areas of our research that have been our strengths include cancer genomics and microRNA biology. We are developing expertise in drug delivery, with a focus on nano-technology driven delivery of microRNA mimics and antagomiRs, which will be further developed in the coming year.
CLINICAL: We interact with members of the UT Health San Antonio, Division of Pediatric Hematology-Oncology to provide support for clinical research, banking of clinical specimens, and annotation of such specimens to facilitate patient-oriented research. Our clinical mission includes performing research that translates into clinical care, Greehey CCRI supports infrastructure for human subjects’ research and investigator-initiated trials in pediatric cancer. Since much of research in pediatric cancer includes participation in cooperative group trials, Greehey CCRI supports the involvement of investigators in Children’s Oncology Group participation.
EDUCATION: The educational mission of the Greehey Children's Cancer Research Institute is to train the next generation of researchers in pediatric cancer research. This includes creating a pipeline of trainees through our program for undergraduates engaged in summer research, medical students within the MD with Distinction in Research program, fellows in the ACGME-approved hematology-oncology fellowship program, as well as the traditional graduate programs in Cancer Biology and other relevant areas.
Offices: 8403 Floyd Curl Dr, San Antonio, Texas, US
Childhood CancerBioInformaticsCancer ControlCancer GeneticsGenomic SequencingPediatric Cancer SurvivorshipRecombination DNA RepairSystems BiologyComputational BiologyDrug Discovery
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