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Claims Verification Operator

Company: Kelsey-Seybold
Location: Pearland
Posted on: June 6, 2021

Job Description:

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.

 


The Scan Operator is tasked with Claims Preparation and Batching of claim forms and correspondence within EPIC (Tapestry). The Scan Operator will utilize DataCap software to perform scanning and verification procedures of claim forms (UB04, CMS 1500 and Correspondence) which includes batch verification, document integrity review, page type, document form type verification, attachment review and confirmation functions. The Scan Operator will also perform data and image comparisons relative to Claim Data (billed amount, units, dates, CPT Codes, Diagnosis Codes, additional Insurance Information, member demographic Information, Provider/Vendor selection and Benefit information. The Operator will complete Data correction tasks for discrepancies, create discrepancy log, create inventory log of claims received by individual healthplans. Additional tasks include claim (logging) number assignment of (paper claims) into Tapestry. (Vendor Set-Up/Benefit Inquiry) rules will apply.


Claims Verification Operator

Location: Pearland Administrative Office

Department: Claims 

Job Type: Full Time 

 

EDUCATION REQUIREMENTS & EXPERIENCE REQUIREMENTS

(A = basics; B = preferred)

 

Education

A.

High School diploma or GED from an accredited program 

B.

 

Experience

A.

2 years of general office or medical insurance or 1 year of claims Preprocessing Experience

 

B.

ICD9/CPT Coding. Knowledge of medical terminology.

 

Licenses

A.

 N/A

 

B.

 N/A

Special   Skills

A.

 

 

B.

EPIC Tapestry Experience    

 

Other

A.

Good verbal and written communication skills, professional appearance, positive attitude. Ability to function in a fast paced work environment

 

B.

Knowledge of HMO,PPO, and POS Healthplans.

 

WORKING ENVIRONMENT

Office

Keywords: Kelsey-Seybold, Pearland , Claims Verification Operator, Other , Pearland, Texas

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