Claims Recovery Analyst- Kelsey Seybold Clinic

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.

Primary Responsibilities

• Analyst will 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
  
  

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications

• 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. (Senate Bill 418)
  
  

Preferred Qualifications

• 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
  
  

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $17.98 to $32.12 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.