Job description
Overview:
Kelsey-Seybold Clinic, a Houston tradition in patient-centered care, is a multispecialty clinic with over 25 locations and comprises more than 500 physicians providing primary and specialty care in a collaborative manner.
With 55 different clinical and non-clinical specialties, you can design a career path at Kelsey-Seybold Clinic that allows you to grow your future in a completely new direction.
Kelsey-Seybold Clinic is changing the way health cares.
Responsibilities:
EDUCATION REQUIREMENTS & EXPERIENCE REQUIREMENTS
Education
A.
Associates degree in Business Administration or
related field; or successful completion of Coding
and Billing Certificate Program.
Experience
A.
Requires 3 or more years current experience
in a health care billing and collection
environment or relevant health care setting
using an accounting/health care computer
system; or one year of related experience
with preferred education.
B.
5 years’ experience in a healthcare business
office setting, preferably in electronic claims
billing or insurance follow up. Epic Professional
Billing experience a definite plus as is an
understanding of a diversity of insurance plans.
Licenses
A.
B.
Communication
A.
B.
Special Skills
A.
Understanding of billing invoice activity such as
credits, debits, adjustments, contractual
agreements, etc.
A.
WORKING ENVIRONMENT
Kelsey-Seybold Clinic, a Houston tradition in patient-centered care, is a multispecialty clinic with over 25 locations and comprises more than 500 physicians providing primary and specialty care in a collaborative manner.
With 55 different clinical and non-clinical specialties, you can design a career path at Kelsey-Seybold Clinic that allows you to grow your future in a completely new direction.
Kelsey-Seybold Clinic is changing the way health cares.
Responsibilities:
Under the supervision of the Business Services Supervisor, the Claims Processing Specialist will drive speed to payment and improved
revenue yield in a fast-paced environment by ensuring all claims are submitted to the payor timely and accurately. Tasks include resolution
of all assigned claim edits. In the event a claim edit does not pass, the Representative must determine the root cause of the claim
submission exception and take the necessary actions, including but not limited to insurance verification, to resolve the claim issue. The
Claim Submission & Follow-Up Representative determines claims status of no reject/no response claims and follows Kelsey-Seybold Clinic
Central Business Office policies and procedures to take appropriate follow-up action to affect resolution of the claim. The Representative is
required to meet work productivity standards and performance measures for this position. Professionalism and courtesy are expected when
communicating with external contacts to resolve claims issues and patients to explain financial liability, advise of non-coverage, process
payments and payment plans, and clarify Explanation of Benefits and statement of physician services. Exhibits exceptional customer skills
to provide the patient with a positive service experience.
Qualifications:
revenue yield in a fast-paced environment by ensuring all claims are submitted to the payor timely and accurately. Tasks include resolution
of all assigned claim edits. In the event a claim edit does not pass, the Representative must determine the root cause of the claim
submission exception and take the necessary actions, including but not limited to insurance verification, to resolve the claim issue. The
Claim Submission & Follow-Up Representative determines claims status of no reject/no response claims and follows Kelsey-Seybold Clinic
Central Business Office policies and procedures to take appropriate follow-up action to affect resolution of the claim. The Representative is
required to meet work productivity standards and performance measures for this position. Professionalism and courtesy are expected when
communicating with external contacts to resolve claims issues and patients to explain financial liability, advise of non-coverage, process
payments and payment plans, and clarify Explanation of Benefits and statement of physician services. Exhibits exceptional customer skills
to provide the patient with a positive service experience.
Claims Processing Specialist
Location: Pearland Administrative Office
Department:Business Office - Goverment & Corporate
Job Type: Full Time
Salary Range: $34,744 to $45,601.50
(Pay is based on several factors including but not limited to education, work experience, certifications, etc.)
EDUCATION REQUIREMENTS & EXPERIENCE REQUIREMENTS
(A = basics; B = preferred)
Education
A.
High School diploma or GED from an accredited institution
B.
Associates degree in Business Administration or
related field; or successful completion of Coding
and Billing Certificate Program.
Experience
A.
Requires 3 or more years current experience
in a health care billing and collection
environment or relevant health care setting
using an accounting/health care computer
system; or one year of related experience
with preferred education.
B.
5 years’ experience in a healthcare business
office setting, preferably in electronic claims
billing or insurance follow up. Epic Professional
Billing experience a definite plus as is an
understanding of a diversity of insurance plans.
Licenses
A.
B.
Communication
A.
B.
Special Skills
A.
Basic PC and Internet literacy. Must be
familiar with laws and regulations governing
Medicare billing practices, medical billing
systems, and claims processing. Good
problem-solving skills. Ability to handle a
variety of tasks with speed, attention to detail
and accuracy.
familiar with laws and regulations governing
Medicare billing practices, medical billing
systems, and claims processing. Good
problem-solving skills. Ability to handle a
variety of tasks with speed, attention to detail
and accuracy.
B.
Understanding of billing invoice activity such as
credits, debits, adjustments, contractual
agreements, etc.
Other
A.
Excellent interpersonal communications skills
and ability to communicate effectively both
orally and in writing with patients, physicians,
management, and third-party
representatives.
and ability to communicate effectively both
orally and in writing with patients, physicians,
management, and third-party
representatives.
B.
WORKING ENVIRONMENT
Office
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