Revenue Cycle Integrity Specialist - Kelsey… at Optum · Pearland

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.

Primary 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

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:

• 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

Preferred Qualifications:

• Certified Professional Coder (CPC) or Certified Coding Specialist - Physician Based (CCS-P) Certified Coding Associate (CCA)
• Experience with EPIC

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

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 $24.00 to $43.00 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.

OptumCare 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.

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