Legacy Community Health Services Billing Specialist - Chase in Houston, Texas

Legacy Community Health is a premium, Federally Qualified Health Center (FQHC) that provides comprehensive care to community members regardless of their ability to pay. Our goal is to treat the entire patient while improving their overall wellness and quality of life, in addition to providing free pregnancy tests, HIV/AIDS screening. At Legacy, we empower patients to lead better lives by promoting healthy behaviors and offering resources such as literacy classes, family planning services, and nutrition and weight management information.

Our roots began in 1981 as the Montrose Clinic, with specialization in HIV education, testing, and treatment. Since then, the agency has expanded to 10 clinics in Houston, one in Baytown, two in Beaumont, and one in Deer Park with extensive services that include: Adult primary care, HIV/AIDS care, pediatrics, OB/GYN and maternity, dental, vision and behavioral health. We also service students within KIPP and YES Prep schools. Legacy is committed to driving healthy change in our communities.

Job Description

Responsible for timely and accurate billing and collections of Medicare, Medicaid and commercial payers. Must possess critical thinking skills and understanding of third party payer payment methods to prepare contractual adjustments correctly based on payer contracts or government regulations. Responsible to submit electronic and paper claims to private and government payers, follow-up on submitted claims in accordance with payer and facility policies, research rejections and denials, document account activity, post adjustments and demonstrate proficiency with billing system to ensure all functionality is utilize for the utmost efficient processing of claims. Responsible to report billing and collection trends, problems and issues that result in delayed claim processing. Responsible to maintain current on all private and government payer billing regulations and policy. Responsible for 30+ day internal audits, EDI rejection reports. Responsible for the organization of departmental “special projects”.

Essential Functions

  • The ability to read, communicate via telephone and/or website with out of state providers, insurance companies and the Chase Brexton team regarding – explanation of benefits, claims processing, coding questions, payments and any other office related questions that may arise relating to billing.

  • Performs follow up with insurance companies on unpaid insurance accounts identified through aging reports.

  • Responsible for maintaining and/or creating patient accounts within medical software program. Assesses accuracy of demographic and policy information within patient accounts. Photocopies patients' identification and/or insurance cards as appropriate.

  • Responsible for charge and payment entry within medical software program. Coordinates and clarifies with providers when necessary, information that seems incomplete or is lacking for proper account/claim adjudication.

  • Reviews patient insurance policy information and works with providers to obtain authorization and referrals, as necessary. Updates this information within medical software program.

  • Assists in reconciling deposit and patient collections.

Job Requirements

  • High School Diploma/GED

  • Minimum of 4-6 years of related experience in a business, medical or technical environment

  • Previous experience in a medical office setting and/or experience with an Electronic Medical Record a plus.

  • Some training or background in ICD-A / CPT codes preferred.

  • Knowledge of medical terminology and billing practices preferred.

  • Customer service driven.

  • Understanding of medical terminology and insurance laws/guidelines.

Benefits

  • 9 Holiday + 1 Floating Holiday

  • PTO

  • 403b Retirement Plan

  • Medical / Vision / Dental (if eligible)