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Insurance Follow Up Specialist
Margie and Bill Klesse College of Engineering and Integrated Design at UTSA. Initiate insurance follow-up on unresolved appealed or unpaid claims to ensure maximum and timely reimbursement .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in medical claims follow-up, appeals processing, and patient billing within a healthcare environment. Proficient in navigating insurance systems and collaborating with various departments to resolve claim issues efficiently.
Highest-signal resume keywords
Medical Claims Follow-UpInsurance Appeals ProcessingPatient Billing ProceduresEPIC ExperienceMicrosoft Office Proficiency
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Claims Status VerificationPre-Authorization ScreeningMedical Records SubmissionClaim Rejection AnalysisDetail OrientationMulti-TaskingOrganizational SkillsTimely ReimbursementInsurance Eligibility VerificationEmergent Requirement Handling
Soft Skills
CollaborationCommunicationCustomer ServiceProblem-Solving
Tools & Technologies
Practice Management SystemPayor PortalsExperianTriZetto/Claim Logic
Certifications & Qualifications
HS DiplomaGED
Industry Keywords
HealthcareBillingReimbursementClaim DenialsInsurance CorrespondenceManaged Care OperationsProvider EnrollmentClinical Operations
About the role
Key responsibilities & impact- Initiate insurance follow-up on unresolved appealed or unpaid claims to ensure maximum and timely reimbursement
- Submit appeals and reconsiderations on claim denials via practice management system, payor portals, or mail
- Analyze daily claim rejections from the clearing house
- Screen claims for pre-authorization and request and submit medical records
- Collaborate with Coding, Payment Posting, Managed Care Operations, Provider Enrollment, and Clinical Operations to resolve claim issues
- Review and respond to insurance correspondence related to recoupments, refunds, eligibility, or additional payor requests
- Assist the customer service team with patient billing concerns or disputes
- Verify patient benefits and insurance eligibility
- Perform claims status verification and navigate insurance websites for payor guidelines
- Communicate findings to insurance companies, management, and clinical departments
- Complete other duties as assigned
Requirements
What you’ll need- 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 coordinate work within schedule constraints and handle emergent requirements in a timely manner
- Ability to multi-task in a fast paced, high-volume environment
- Proficient in Microsoft Office
- EPIC experience
- Experian, TriZetto/Claim Logic
- HS Diploma or GED
- Three (3) years hospital business office or medical billing related experience
Benefits
Comp & perks- UT SELECT Medical insurance offered free for employees
- Family medical coverage available through payroll deduction
- Discounted copays and coinsurance through UT Health Physicians
- $50,000 group term life insurance provided free
- $50,000 basic accidental death and dismemberment insurance provided free
- Optional additional employee and dependent life and AD&D coverage at group rates
- Three dental insurance plan options, including two PPOs and one HMO
- Two vision plan options with standard or enhanced benefits
- Disability insurance
- Flexible spending accounts for dependent care and healthcare expenses
- Teacher Retirement System (TRS) or Optional Retirement Plan (ORP)
- Employer matching of employee contributions under TRS
- Voluntary retirement programs with five plan providers
- Front-loaded paid time off: 128 to 208 hours (16 to 26 days), based on years of service
- Extended Illness Bank: 8 hours accrued per month
- Paid Family Leave: up to 240 hours (6 weeks) after 6 months of consecutive employment
- 12 paid holidays annually
- Discounts on services, tickets, and gym membership