**Responsibilities** This position identifies and implements cost containment processes to maximize revenue, creating queries and reports to analyze claims cost trends. It synthesizes data into reports, validates data, and presents issues and trends to management while communicating with carriers and health plan representatives about audits and inquiries. The role handles all cost containment activities related to other coverage, third-party liability, including investigations, data reconciliations, and updates to health plan systems. It determines the order of benefits for individuals with multiple healthcare policies and ensures accurate coordination of benefits. The Specialist validates data, identifies discrepancies, resolves issues, and collaborates with stakeholders to optimize benefit utilization and minimize costs. The role also involves conducting outbound calls to validate coordination of benefits information and proactively resolving COB issues. **Job Title: Medicare Benefits Validation Analyst** **Location: Pearland Administrative Office** **Department:** **Kelseycare Operations** **Job Type: Full Time** **Salary Range: $59,108 - $73,025 (Pay is based on several factors including but not limited to education, work experience, certifications, etc.)** **Qualifications** **Education** Required: Bachelor’s degree in business or healthcare administration Preferred: N/A **Experience** Required: 5 years of progressive experience within a health plan, managed care organization, or other healthcare entity to include eligibility, benefits, coordination of benefits, customer service, and third-party coverage Preferred: Prior experience with Medicare Advantage including knowledge of regulations, products, and processes. Prior experience with third-party liability Collections and recoveries experience **License(s)** Required: N/A Preferred: N/A **Special Skills** Required: Excellent presentation and communication skills Working knowledge of managed care reporting and analytics Ability to analyze and interpret data and technical reports using Microsoft Excel and Access to synthesize findings to report to management. Strong Analytical Skills Preferred: Working knowledge of EPIC Tapestry system related to enrollment and eligibility, other coverage, and coordination of benefits **Other** Required: Ability to communicate complex information in a clear and concise manner. Ability to work in a fast-paced, deadline-oriented environment. Flexible; able to work independently or in a team environment Preferred: Self-Directed **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 Kelsey-Seybold Clinic strives to provide equal opportunity employment without regard to race, color, religion, age, national origin, sex, gender, sexual orientation, gender identity/expression, genetic information, disability, veteran status, or any other basis protected by organizational policy or by federal, state, or local laws unless such distinction is required by law. Kelsey-Seybold is a VEVRAA Federal Contractor and desires priority referrals of protected veterans.