This position is hybrid. May have in-person meetings in Houston, TX office.

Be a part of driving healthy change in our communities

About the Position

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”. 

Key Responsibilities

• 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.
• Assist in Credentialing providers with various managed care companies. Maintains and responds to requests for provider licensure or other information needed to maintain active status with affiliated organizations.
• Reviews provider schedules and screens patient financial/ demographic information for accuracy. Coordinates with Front Desk staff to update patient records as needed.
• 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.
• Coordinates with Front Desk staff regarding collections of current or past due patient balances, co-pays, deductible, etc. Available to answer billing and charge related inquires by patients, staff s, and managed care organizations, etc.
• Participates in the Performance Improvement Program.
• Assist with all Billing Audit related information
• Assist with questions from billing staff membered.
• Performs other duties as assigned.

About Legacy Community Health

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.

Requirements

• High School Diploma or GED required

• 5-8 years of billing experience required

Benefits

• Medical, Dental, and Vision insurance
• Long-Term Disability insurance
• Life insurance and AD&D
• 403(b) retirement plan
• Employee Assistance Plan
• Subsidized gym membership
• 24-hour travel assistance
• Paid Time Off 
• PTO Exchange Program
• Company holidays (9 days + 1 floating day)
• Bereavement Leave
• And more

Legacy Community Health is an Equal Opportunity Employer that welcomes and encourages diversity in the workplace.

Apply today.

Our short application process takes less than 3 minutes on your phone, tablet or computer.