Responsible for timely and accurate billing, monitoring and collections of Medicaid, Managed Medicaid payers, and private insurance payers. Must possess critical thinking skills and understanding of Medicaid Eligibility requirements and 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 Medicaid, Managed Medicaid payers, and private insurance 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.
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 >50 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.