Claims Recovery Analyst - Business Office - Kelsey Seybold

UnitedHealth Group • Pearland, TX

110d • $23 - $41 • Onsite

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. This position requires research of all Claims when suspended for dual coverage, pre-existing research, and coordination of benefits investigation.

Requirements

• High School diploma or GED from an accredited program.
• 2+ years of Managed Care Experience in Claims Administration with KSC as Claims Analyst or Provider Service Representative or 3 years of Claims Payment, Claims Billing, or Coordination of Benefits Experience in another Healthcare environment.
• Understanding and interpretation of Managed Care claims payment process including electronic claims adjudication, contractual agreements, Financial Obligation Summaries, L.O.A.'s, Medicare/HCFA guidelines, Coordination of Benefit rules, State mandated processes specific to recovery and claims payment requirements.

Nice To Haves

• 1+ years of Claims Collections or Recovery experience.
• Knowledge of Direct Provider Network Product.
• Self-directed and able to absorb new information quickly.
• Knowledge of ICD-9, CPT Codes.

Responsibilities

• Apply coordination of benefits procedures to claims with confirmed dual coverage via use of the Epic Systems.
• Add/modify filing order information in EPIC System as well as documenting COB information in the system.
• Refund posting via EPIC system.
• Prepare monthly summary and forward payments received to accounting department.

Benefits

• Comprehensive benefits package.
• Incentive and recognition programs.
• Equity stock purchase.
• 401k contribution.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Industry: Insurance Carriers and Related Activities
• Education Level: High school or GED