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Hours Full-time, Part-time
Location San Antonio, TX
San Antonio, Texas

About this job

WellMed is now part of the OptumHealth division under the greater UnitedHealth Group umbrella.


 


WellMed is a healthcare delivery system serving more than 90,000 patients, primarily Medicare eligible seniors, in Texas and Florida through primary care clinics, multi-specialty clinics, and contracted medical management services.  Headquartered in San Antonio, Texas, WellMed is an industry leader in medical risk management, highly effective disease management and chronic care programs, healthcare delivery services and more.


 


Our focus and mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness.  We are innovators in preventative healthcare, striving to change the face of healthcare delivery for seniors.  Our providers and support staff are selected for their dedication to the senior population and focus on preventative, proactive patient care.


 


Job Summary
This position is accountable for managing staff for medical billing and collections operations to ensure timely and accurate submission of claims and encounter data.  In addition, this position manages system issues, provides reporting and analysis to management, ensure compliance with regulatory requirements, represent the department as a knowledge holder on billing issues, and interfaces with other departments.


 


Essential Job Functions



  • Develop and implement departmental processes to ensure compliance with state and federal laws and, regulations for Medicare, Medicaid, managed care and other third party payers related to medical coding, billing procedures, and documentation.

  • Establish departmental production and quality goals in managing staff in the use of multiple practice management and medical billing software.

  • Serve as resource to departmental staff concerning coding changes, compliance issues, and systems requirements.

  • Monitor daily operating activity of department.  Assure accurate and timely processing of medical claims. Monitor and track performance.

  • Develop and implement quality assurance processes for system issues related to billing errors or audits.

  • Monitor regulatory changes that impact the claims/encounter submission process. Identify change requirements for existing systems and processes.

  • Maintain timely knowledge of mandatory billing and coding changes/requirements.

  • Serve as liaison in communicating with Doctors, upper management, staff in clinics, and other departments. 

  • Identify and implement policies, procedures, and operations that optimize efficiency, financial performance, and process integrity. 

  • Participate in planning, design, implementation and measurement of quality improvement processes and systems.

  • Manage, train, mentor, motivate, and evaluate performance of assigned staff.

This position is located in San Antonio, TX

Requirements


  • Bachelor's degree preferred or at least 7 years in healthcare industry with experience in medical billing and health insurance.

  • Experience working with different practice management and medical billing software with expertise in managing charge entry, cash posting, A/R management, and medical coding. 

  • Knowledge of legal, regulatory, and policy compliance issues related to medical coding and billing procedures and documentation. 

  • Experience with Medicare and other regulations and credentialing requirements

  • Coding Certification preferred (CPC, CMIS, CMC, CCS, CCS-P).

  • Intermediate Proficiency with Microsoft Office programs, including Word, Excel, Outlook.

Preferred Education, Experience & Skills



  • More than five years experience with medical billing and collections. 

Physical & Mental Requirements:



  • Ability to lift up to 25 pounds

  • Ability to sit for extended periods of time

  • Ability to use fine motor skills to operate office equipment and/or machinery

  • Ability to receive and comprehend instructions verbally and/or in writing

  • Ability to use logical reasoning for simple and complex problem solving

Diversity creates a healthier atmosphere: All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, protected veteran status, or disability status.


 


UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.