Pearland, TX, United States
14 hours ago
Data Intake Specialist-Claims

Responsibilities

The Data Intake Specialist is responsible for accurately entering, reviewing, and validating data in departmental processing systems, maintaining a 99% accuracy standard. This role processes mail, including faxes, emails, written correspondence, and calls from Member Services, while requesting and adding necessary documents from members and providers. The Specialist also provides critical support to the Appeals & Grievances, Billing, Coordination of Benefits, and Enrollment teams by ensuring accurate data entry and seamless communication across these functions.

 

This position supports the provider dispute process by performing front-end data entry and administrative tasks, including entering disputes into the Epic system, conducting initial case assessments, and creating necessary documentation in the CRM system. The Specialist also reviews and analyzes departmental reports, escalating issues and trends to management as needed.

 

In addition, the Specialist identifies and implements workflow improvements, provides technical insights, and recommends future department strategies and system enhancements. They collaborate with internal and external departments, including Appeals & Grievances, Billing, Coordination of Benefits, and Enrollment teams, to optimize workflows and support system upgrades through testing and feedback.

 

Job Title: Data Intake Specialist-Claims


Location: Pearland Administrative Office


Department: Claims


Job Type: Full Time 


Salary Range: $39,179 -  $48,397  (Pay is based on several factors including but not limited to education, work experience, certifications, etc.)

 

Qualifications


Education


Required: High School Diploma or equivalent.


Preferred: Some college of technical school.


Experience


Required: 1-3 years Healthcare Industry.

 

3-5 years’ Customer Service Experience. 

 

1 Year Quality Assurance Experience.


Preferred: 1-2 years background in Claims.

 

3 years exp ASO Products / Managed Care.

 

Experience with Medicare Guidelines.

 

Experience with EPIC CRM. 

 

Experience CMS MARx system.


License(s)


Required: N/A


Preferred: N/A


Special Skills


Required: 3 – 5 years with various applications to include: Excel, Word, and Microsoft Edge.

 

Ability to communicate technical concepts to technical and non-technical people.


Preferred: Experience operating office equipment. (Fax Machine, Scanners).

 

Experience with CMS and/or claims appeals process.


Other 


Required: Excellent Written and Verbal Communication Skills while being detail oriented, and work with 

 

minimum supervision to meet strict regulatory guidelines.

 

Be flexible, able to work overtime as needed.

 

Strong organizational skills and ability to follow through with multiple tasks.

 

In Office Only - No remote option available.


Preferred: N/A

 

Working Environment: Office

 

About Us


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

 

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