Claims Processing Specialist – Kelsey Seybold Clinic – Pearland Admin Office

Job ID : 2336963

Job Type : Full-time

Location : Pearland, TX 77581

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.

This position has potential of Hybrid schedule. Hours may be flexible. Candidates must reside in Texas.

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.

Required Qualifications :

• 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

Preferred Qualifications :

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you’ll find a far-reaching choice of benefits and incentives. The salary for this role will range from $xx,xxx to $xx,xxx annually based on full-time employment. We comply with all minimum wage laws as applicable.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes – an enterprise priority reflected in our mission.

OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.