Ensures accurate coding and reimbursement of claims submitted to third-party payors. Ability to perform analysis of patient account and review chart notes to validate accuracy of CPT, ICD10 & HCPCS codes. Ability to abstract information from the patient chart and update provider procedural and diagnosis coding as needed. Work with Accounts Receivable team to analyze denials, interpret medical policies and assist with preparation of appeals. Apply analytical skills to daily work to identify and improve processes. Perform in-depth research and review of denial trends with solutions to mitigate future claim rejections. Provide coding support to multiple departments within the Business Office. Able to communicate clearly with physicians and administrative staff. Attend seminars and maintain certification. Multi-specialty coding experience is desired. Ability to analyze, audit and reconcile an account is critical to this position.
Job Title: Claims & Reimbursement Specialist
Clinic Location: Pearland Administration Office Building
Department: Business Office -Reimbursement Specialist
Job Type: Full Time
Salary Range: $53,123 – $65,624 (Pay is based on several factors including but not limited to education, work experience, certifications, etc.)
Required: Associates degree in Business Administration or related field may substitute for 2 years of experience
Required: 3-4 years ICD 10 CPT, HCPCS coding/abstracting and healthcare billing and collections experience. Diversified understanding of rules and regulations of Commercial Insurance and CMS guidelines. Working knowledge of commercial insurance and CMS. Knowledge of commercial payor policies, NCCI edits and EOB’s.
Preferred: 5-6 years of experience in health care billing and collection. Knowledge of secondary or supplemental insurance claim filing (COB) is a plus. Experience with EPIC.
Required: Certified Professional Coder (CPC) or Certified Coding Specialist –Physician Based (CCS-P) Certified Coding Associate (CCA)
Required: Understanding of EOB’s, strong PC skills. Familiar with commercial payor websites & tools. Presentation skills. Excellent written and verbal communication skills.
Required: Must be able to retain composure, meet deadlines, and appropriately analyze, research, and resolve problems in a stressful environment with constant work-related interruptions. Must demonstrate dependability and an ability to work independently.
Working Environment: Office
Start your career journey and become a part of a community of renowned Healthcare professionals. Kelsey-Seybold Clinic is Houston’s fastest growing, multispecialty organization with more than 40 premier locations and over 65 specialties. Our clinics are comprised of more than 600 physicians and as we continue to grow, our focus is providing quality patient care by adding to our team of clinical and non-clinical professionals that work together in a convenient, coordinated, and collaborative manner. Enjoy the rewards of a successful career while maintaining a work/life balance by joining our team today and changing the way health cares.
Why Kelsey-Seybold Clinic?
- Medical, Vision, and Dental
- Tuition Reimbursement
- Company Matching 401K
- Employee Reward and Recognition Program
- Paid time off for vacation, sick, and holidays
- Employee Assistance Program
- Continuing Medical Education allowance