Collections Representative - San Antonio, TX

Careers at UnitedHealth Group

We're creating opportunities in every corner of the health care marketplace to improve lives while we're building careers. At UnitedHealth Group, we support you with the latest tools, advanced training and the combined strength of high caliber co-workers who share your passion, your energy and your commitment to quality. Join us and start doing your life's best work. SM


Compassion. It's the starting point for health care providers like you and it's what drives us every day as we put our exceptional skills together with a real feeling of caring for others. This is a place where your impact goes beyond providing care one patient at a time. Because here, every day, you're also providing leadership and contributing in ways that can affect millions for years to come. Ready for a new path? Learn more, and start doing your life's best work. SM

Our teams are helping people from around the world. We can bring out your best as you put your listening, analytical and problem solving skills to work in a setting that is geared to helping improve lives and enhance health care for millions. Here, you'll discover a wealth of pathways for professional growth within Customer Service, Billing, Claims, Enrollment & Eligibility and across our global economy. Join us and find out why this is the place to do your life's best work. SM

Job Summary

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.

Essential Job Functions may include any or all of the following as assigned:
  • 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 apply 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.
  • Able to prepare documents for training or for establishing procedures for clinics.
  • Answers patient and customer questions regarding billing and statements.
  • Performs all other related duties as assigned.

  • Minimum Required Education, Experience & Skills
    • High school diploma or GED equivalent required.
    • Two or more years of relevant experience in the healthcare industry, with a focus on medical terminology
    • Skill in using Microsoft Office (Outlook, Excel, Word).
    • Full COVID-19 vaccination is an essential requirement of this role. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination prior to employment to ensure compliance

    Preferred Education, Experience & Skills
    • Technical skills in the areas of EDI, systems analysis and process flows.
    • Srong attention to detail and professional customer service skills required.
    • Coding certification preferred but not required.
    • Skill in the operation of billing software and office equipment.
    • 50wpm typing skill preferred.
    • Skill in processing claims efficiently and on a timely basis.
    • 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 processing claims efficiently and on a timely basis.
    • Solid customer service skills and excellent interpersonal skills.
    • Attention to detail.
    • Solid customer service skills and excellent interpersonal skills.

    UnitedHealth Group requires all new hires and employees to report their COVID-19 vaccination status.

    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 550,000+ 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: Collections Representative, Healthcare, health care, Managed Care, Billing Representative, Billing, Collections, Claims, Customer Service, Medical Billing, San Antonio, TX, Texas