Claims Processing Specialist- Kelsey Seybold Clinic: Pearland Admin Office

About the position Explore opportunities with Kelsey-Seybold Clinic, part of the Optum family of businesses. Work with one of the nation s leading health care organizations and build your career at one of our 40+ locations throughout Houston. Be part of a team that is nationally recognized for delivering coordinated and accountable care. As a multi-specialty clinic, we offer care from more than 900 medical providers in 65 medical specialties. Take on a rewarding opportunity to help drive higher quality, higher patient satisfaction and lower total costs. Join us and discover the meaning behind Caring. Connecting. Growing together. Position in this function is under the supervision of the Business Services Supervisor, the Claim Processing Specialist is responsible for processing the electronic claims edits, front end edits, as well as claims edits from secondary claims. In the event a claim edit does not pass, the Specialist must determine the required action and steps necessary to resolve the claim issue. The Claim Processing Specialist will be expected to review and resolve a No-Activity Work file/Work queue, which consist of accounts that have no payment or rejection posted on the account and follow Kelsey-Seybold Clinic Central Business Office policies and procedures to determine the appropriate action. The Specialist will be expected to follow up with daily workloads and also be able to meet work standards and performance measures for this position. If you are located in Pearland, TX, you will have the flexibility to work remotely as you take on some tough challenges. You ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Responsibilities

• processing the electronic claims edits, front end edits, as well as claims edits from secondary claims
• determine the required action and steps necessary to resolve the claim issue
• review and resolve a No-Activity Work file/Work queue
• follow Kelsey-Seybold Clinic Central Business Office policies and procedures to determine the appropriate action
• follow up with daily workloads
• meet work standards and performance measures for this position

Requirements

• High School diploma or GED
• 3+ years of billing experience, knowledge of healthcare business office functions and their relationships to each other. (i.e. billing, collections, customer service, payment posting) and insurance products such as managed care, government and commercial products
• Familiar with laws and regulations governing Medicare billing practices, medical billing systems, and claims processing
• All employees working remotely will be required to adhere to UnitedHealth Group s Telecommuter Policy

Nice-to-haves

• 3+ years of experience in a healthcare business office setting, preferably in electronic claims billing, or insurance follow up
• IDX/EPIC, PC skills, and understanding of billing invoice activity such as credits, debits, adjustments, contractual agreements, etc.
• Additional training as a medical office assistant, medical claims processor, or medical claims follow up specialist

Benefits

• In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements).

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