Healthcare Insurance Collections Clerk - San Antonio, Tx

Careers that Change Lives
As a key member of the Patient Financial Services (PFS) team, responsible for all aspects of billing, credit and collection activities, including customer service with an objective of maximizing cash flow and keeping DSO to a minimum.
The Insurance Collection role follows prescribed procedures and procedures, performs a variety of tasks using standard healthcare guidelines. Main objective is follow up collection activities including rebilling, appeals and recovery activities for denied or short paid claims. Verifies accuracy of statements (patient and payor related) as well as other healthcare financial accounting documentation or records. Enters data into computer systems using defined computer resources and programs. Compiles data and prepares a variety of reports. May reconcile records with PFS team members and leaders; communicates with external vendors and customers (including representatives of health plans/payors.) Recommends actions to resolve discrepancies; investigates questionable data.
Diabetes Operating Unit:
The Diabetes Operating Unit focuses on improving the lives of those within the global diabetes community. As a business, we strive to empower people with diabetes to live life on their terms by delivering innovation that truly matters and providing support in the ways they need it. We're committed to meeting people with diabetes where they are in their journey, always with an aim to make their lives easier. Our portfolio of innovative solutions is designed to provide customers greater freedom and better health, helping them achieve better glucose control, while spending less time managing their disease.
Act boldly. Compete to win. Move with speed and decisiveness. Foster belonging. Deliver results...the right way.
A Day in the Life
Responsibilities may include the following and other duties may be assigned.

• Executes on established departmental objectives and assignments which affect the immediate operation, but that also have full revenue cycle and company-wide fiscal impact.
• Initiates follow-up activities with third-party payors regarding open claim balances; makes written and verbal inquiries to payors.
• Analyzes and problem solves account issues to full resolution.
• Manages internal and external customer/business inquiries regarding account status and account history.
• Research issues off-line as needed with payor/patient; conducts follow-up calls with payors and customers, initiating conference calls between insurance carrier and patients to resolve customer concerns.
• Researches and initiates refund requests due to overpayments by payor and/or patient.
• Determines when claims/accounts are deemed uncollectable; recommends and initiates bad debt write-offs procedures.

Must Have: Minimum Requirements
To be considered for this role, please ensure the minimum requirements are evident on your resume.

• High School Diploma or equivalent.
• Two years of experience in Insurance Collections, billing, or insurance authorization in a healthcare setting

Nice to Have

• Demonstrated ability to prioritize work, managing daily and multiple tasks to completion within the time allotted
• Ability to prepare forms, spreadsheets, and graphs.
• Experience in a payor or medical provider community that deals with all aspects of the revenue cycle.
• Experience with reviewing and analyzing insurance payments, and/or payer adjudication claims against contract terms and patient coverage and benefits.
• Experience reading and understanding the information provided on EOBs, remittance advices, and other insurance correspondence, and in calculating patient responsibility taking into consideration coverage and benefits, including referral, authorization, and/or pre-determination requirements, and contract terms.
• Experience with various insurance plans offered by both government and commercial insurances (i.e., PPO, HMO, EPO, POS, Medicare, Medicaid, HRA's) and coordination of healthcare benefits, including requirements for referral, authorization, and pre-determination.
• Experience with medical billing and collections terminology - CPT, HCPCS and ICD-10 coding.
• Experience with HIPAA guidelines and healthcare compliance.
• Previous experience in receiving and making outbound calls to patients to explain insurance benefits related to health insurance, and/or discussing patient financial responsibilities

About Medtronic
Together, we can change healthcare worldwide. At Medtronic, we push the limits of what technology, therapies and services can do to help alleviate pain, restore health and extend life. We challenge ourselves and each other to make tomorrow better than yesterday. It is what makes this an exciting and rewarding place to be.
We want to accelerate and advance our ability to create meaningful innovations - but we will only succeed with the right people on our team. Let's work together to address universal healthcare needs and improve patients' lives. Help us shape the future.
Physical Job Requirements
The physical demands described within the Responsibilities section of this job description are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. For Office Roles: While performing the duties of this job, the employee is regularly required to be independently mobile. The employee is also required to interact with a computer, and communicate with peers and co-workers. Contact your manager or local HR to understand the Work Conditions and Physical requirements that may be specific to each role. (ADA-United States of America)
A commitment to our employees lives at the core of our values. We recognize their contributions. They share in the success they help to create. We offer a wide range of benefits, resources, and competitive compensation plans designed to support you at every career and life stage. Learn more about our benefits here.
This position is eligible for a short-term incentive plan. Learn more about Medtronic Incentive Plan (MIP) here.
The provided base salary range is used nationally in the United States (except in Puerto Rico and certain CA locations). The rate offered is compliant with federal/local regulations and may vary by experience, certification/education, market conditions, location, etc.