Optum ยท 3 days ago
Claims Processing Specialist - Kelsey Seybold Clinic - Pearland Admin Office
Pearland, TX
Full-time
Hybrid
Mid Level
3+ years expOptum is part of the Kelsey-Seybold Clinic, a leading healthcare organization in Houston. The Claims Processing Specialist is responsible for processing electronic claims edits and resolving claim issues while following clinic policies and procedures.
EducationHealth CareMedicalPharmaceutical
Responsibilities
Processing the electronic claims edits, "front end "edits, as well as claims edits from secondary claims
Determine the required action and steps necessary to resolve the claim issue
Review and resolve a No-Activity Work file/Work queue
Follow Kelsey-Seybold Clinic Central Business Office policies and procedures to determine the appropriate action
Follow up with daily workloads
Meet work standards and performance measures for this position
Qualification
Required
High School diploma or GED
3+ years of billing experience, knowledge of healthcare business office functions and their relationships to each other. (i.e. billing, collections, customer service, payment posting) and insurance products such as managed care, government and commercial products
Familiar with laws and regulations governing Medicare billing practices, medical billing systems, and claims processing
Preferred
3+ years of experience in a healthcare business office setting, preferably in electronic claims billing, or insurance follow up
IDX/EPIC, PC skills, and understanding of billing invoice activity such as credits, debits, adjustments, contractual agreements, etc
Additional training as a medical office assistant, medical claims processor, or medical claims follow up specialist
Benefits
Comprehensive benefits package
Incentive and recognition programs
Equity stock purchase
401k contribution
Company
Optum
Optum is a healthcare company that provides pharmacy services, health care operations, and population health management. It is a sub-organization of UnitedHealth Group.
10001+ employees
H1B Sponsorship
Optum has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (648)
2024 (559)
2023 (620)
2022 (851)
2021 (593)
2020 (438)
Funding
Current Stage
Late StageLeadership Team
Daniel Castillo
Chief Executive Officer, Optum Care Delivery
J
Jay Green
Chief Financial Officer
Recent News
2025-11-29
2025-11-19
2025-11-07
Company data provided by crunchbase