• Claims Processing Specialist

    Kelsey-Seybold Clinic (Pearland, TX)


    Responsibilities

    Under the supervision of the Business Services Supervisor, the Claim Edit Follow-Up Representative 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 Follow-Up Representative must determine the required action and steps necessary to resolve the claim issue. The Claim Edit Follow-Up Representative will be expected to review and resolve a No-Activity Workfile/Workqueue, 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 representative will be expected to follow up with daily workloads and also be able to meet work standards and performance measures for this position

     

    Job Title: Claims Processing Specialist

     

    Department:** **BOfc-PrAuth&Clm Edit

     

    Job Type: Full Time

     

    Salary Range: $39,179 - $48,397 (Pay is based on several factors including but not limited to education, work experience, certifications, etc.)

    Qualifications

    Education

    Required: High School diploma or GED

     

    Preferred: Additional training as a medical office assistant, medical claims processor, or medical claims follow

     

    up specialist.

    Experience

    Required: Minimum of 3 years 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.

     

    Preferred: Three or more years’ experience in a healthcare business office setting, preferably in electronic

     

    claims billing, or insurance follow up.

     

    License(s)

    Required: N/A

    Preferred: N/A

     

    Special Skills

     

    Required: Must be familiar with laws and regulations governing Medicare billing practices, medical billing

     

    systems, and claims processing.

     

    Preferred: IDX/EPIC, PC skills, and understanding of billing invoice activity such as credits, debits, adjustments,

     

    contractual agreements, etc.

     

    Other

    Required: N/A

    Preferred: N/A

    **Working Environment:** Office

     

    About Us

     

    Start your career journey and become a part of a community of renowned Healthcare professionals. Kelsey-Seybold Clinic is Houston’s fastest growing, multispecialty organization with more than 40 premier locations and over 65 specialties. Our clinics are comprised of more than 600 physicians and as we continue to grow, our focus is providing quality patient care by adding to our team of clinical and non-clinical professionals that work together in a convenient, coordinated, and collaborative manner. Enjoy the rewards of a successful career while maintaining a work/life balance by joining our team today and changing the way health cares.

     

    Why Kelsey-Seybold Clinic?

     

    + Medical, Vision, and Dental

    + Tuition Reimbursement

    + Company Matching 401K

    + Employee Reward and Recognition Program

    + Paid time off for vacation, sick, and holidays

    + Employee Assistance Program

    + Continuing Medical Education allowance

     

    Kelsey-Seybold Clinic strives to provide equal opportunity employment without regard to race, color, religion, age, national origin, sex, gender, sexual orientation, gender identity/expression, genetic information, disability, veteran status, or any other basis protected by organizational policy or by federal, state, or local laws unless such distinction is required by law. Kelsey-Seybold is a VEVRAA Federal Contractor and desires priority referrals of protected veterans.