Explore opportunities with Kelsey-Seybold Clinic, part of the Optum family of businesses. Join a nationally recognized health care organization focused on coordinated, accountable care across more than 40 locations throughout Houston.
This role supports revenue cycle integrity by helping drive higher quality, higher patient satisfaction, and lower total costs. You will work on charge capture, charge reconciliation, denial management monitoring, and Chargemaster review to support accurate billing and revenue optimization.
If you are located in Pearland, TX, you will have the flexibility to work remotely while taking on challenging and meaningful work.
Primary responsibilities
- Responsible for charge capture, charge reconciliation, and denial management monitoring activities
- Assist with analysis and review of the Chargemaster to ensure an accurate and defensible fee schedule
- Monitor work queues to ensure timely resolution of edits and claim submission
- Complete analytical review of reporting to identify missed revenue opportunities and potential revenue enhancement areas
- Use analytical skills to identify trends and root causes in revenue cycle issues such as missing or delayed charges, lag time, and claim denials
- Communicate clearly and provide education to administrative staff
- Stay current on government and commercial payer updates and billing requirement changes
- Monitor denials to identify trends and recommend solutions
- Work independently, analyze data, and use judgment to make independent decisions
Required qualifications
- Certified Professional Coder (CPC), Certified Coding Specialist - Physician Based (CCS-P), or Certified Coding Associate (CCA)
- 5+ years of experience in professional revenue cycle
- Strong working knowledge of revenue cycle components, including CPT, ICD-10, HCPCS, medical terminology, claims, and EOBs
- Knowledge of commercial insurance and CMS rules, regulations, and guidelines
- Proficiency in Excel, Word, Outlook, PowerPoint, and other applications
- Strong analytical skills
Preferred qualifications
- CPC, CCS-P, or CCA certification
- Experience with Epic
Benefits and perks
- Comprehensive benefits package
- Incentive and recognition programs
- Equity stock purchase plan
- 401(k) contribution
- Career development opportunities
- Remote work flexibility for eligible employees
Location
Texas, US
Employment Type
Full-time
Experience Level
Senior
Remote work allowed
Yes
Posted
2 weeks ago