Quality SER Analyst, Kelsey-Seybold Clinic

UnitedHealth Group • Pearland, TX

136d • $58,800 - $105,000 • Remote

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. You'll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges.

Requirements

• 4 year degree (BA, BS in business or other related field) or comparable Information Systems Application experience or KSC experience (will substitute experience year-for-year to meet education requirements)
• 2+ years of experience with healthcare applications, system design, configuration, or support
• Demonstrated knowledge of claims processing, vendor contracting, and benefit plan building
• Epic Tapestry Proficiency required within 9 months of assuming position
• Epic Benefits Proficiency required within 18 months of assuming position
• Proven solid ability to translate administrative and operating requirements specific to Epic Tapestry System into clear, specific actionable system configurations and understand how to implement those configurations
• Proven ability to test and audit Tapestry system configurations to assure functional accuracy
• Microsoft office including Excel, Teams, Visio
• Proven excellent written and verbal skills. Ability to read and interpret industry documents
• Proven flexible, detail oriented, and able to work within tight deadlines
• Proven to exhibit exceptional customer service to internal and external customers
• Valid Driver's License

Nice To Haves

• 4+ years of experience in a Managed Care environment, preferably using Epic Tapestry
• Experience in a Quality Assurance Role
• Demonstrable knowledge of clinical data sets (CPT, HCPS, ICD-9)
• Proven solid analytical and reporting skills

Responsibilities

• Review, test, and validate Epic Tapestry and Epic Benefit Engine build including but not limited to PVP build (provider, vendor, and place of service), provider contracts, EDI and Eligibility load processes, fee schedule maintenance, implementation and upgrades to software applications, and benefits testing
• Coordinate all testing initiatives, develop test plans and test cases/scripts and identify/implement enhancements to existing test scripts, create/maintain policy and procedure document library for the Tapestry System Support Team, and perform retro-adjudication on a recurring and ad hoc basis
• Provides exceptional customer service to all departments, achieve an in-depth knowledge of Epic software, and develop a close working relationship with business owners and stakeholders
• Other duties as assigned

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: Bachelor's degree