Revenue Cycle Integrity Specialist - Kelsey Seybold Clinic - Pearland
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. If you are located in Pearland, TX, you will have the flexibility to work remotely as you take on some tough challenges.
Requirements
- Certified Professional Coder (CPC), Coding Specialist - Physician Based (CCS-P), Certified Coding Associate (CCA) licenses
- 5+ years of experience in professional revenue cycle, familiar with revenue cycle components (CPT, ICD 10, HCPCS, medical terminology, claims, EOB, etc.)
- Proven working knowledge of commercial insurance and CMS, including rules, regulations, and guidelines
- Demonstrated proficiency in Excel, Word, Outlook, PowerPoint and other applications
- Proven analytical skills
Nice To Haves
- Certified Professional Coder (CPC) or Certified Coding Specialist - Physician Based (CCS-P) Certified Coding Associate (CCA)
- Experience with EPIC
Responsibilities
- Responsible for charge capture, charge reconciliation and denial management monitoring activities
- Assists with analysis and review of Chargemaster to ensure an accurate and defensible fee schedule
- Monitors work queues to ensure timely resolution of edits and submission of claims
- Completes analytical assessment of reporting to identify missed revenue opportunities and areas for potential revenue enhancement
- Applies analytical skills to daily work to identify trends or root causes and provides recommendations to improve processes across the revenue cycle (missing or delayed charges, lag time, claim denials, etc.)
- Able to communicate clearly to provide education to administrative staff
- Keeps abreast of government and commercial payor updates and changes to billing requirements
- Monitors denials to identify trends and recommend solutions
- Ability to work independently, analyze data and use judgement to make independent decisions is critical to this position
Benefits
- a comprehensive benefits package
- incentive and recognition programs
- equity stock purchase
- 401k contribution
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
