Careers At Legacy Community Health Services

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Collection Specialist

Department: Billing
Location: Houston, TX

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, 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.


Essential Functions
Essential functions are those tasks, duties, and responsibilities that comprise the means of accomplishing the job’s purpose and objectives. Essential functions are critical or fundamental to the performance of the job. They are the major functions for which the person in the job is held accountable.

  • Performs follow up with Medicaid insurance companies on unpaid insurance accounts identified through aging reports.
  • Identifies trends, and carrier issues relating to billing and reimbursements.  Reports findings to Team Lead and/or Manager.
  • Processes appeals online or via paper submission.
  • Works independently.
  • Processes billing calls and questions from patients and third party carriers.
  • Analyzing and interpreting that claims are accurately sent to insurance companies.
  • Answers/responds to correspondence related to patient accounts.
  • Communicates daily with internal and external customers via phone calls and written communications.
  • Researches, records findings, and communicates effectively with Manager to achieve optimum performance.
  • Pursues and participates in education to remain current with changes in the Healthcare industry.
  • Maintains patient confidence and protects medical office operations by keeping patient information confidential.
  • Contributes to team effort by accomplishing related results as needed.
  • Other duties as assigned.

Education & Training Requirements

  • High School Diploma/GED

Work Experience Requirements

  • Minimum of two years of related experience in a business, medical or technical environment.
  • Experience working in a Federally Qualified Health Center preferred.
  • Experience in medical/dental collections preferred.
  • Previous experience in a medical office setting and/or experience with an Electronic Medical Record a plus.
  • Customer service driven.
  • Understanding of medical terminology and insurance laws/guidelines. 
  • Excellent organization and time management skills along with excellent oral and written communication skills.
  • Strong team player.
  • Ability to learn quickly, build and maintain long term relationships and work with minimal supervision.
  • Strong written and verbal communication skills; strong analytical, organizational and time management skills required.

Benefits

  • 9 Holiday + 1 Floating Holiday
  • PTO
  • 403b Retirement Plan
  • Medical / Vision / Dental (if eligible)

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