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.

Job Description

Works to achieve organizational and departmental goals by serving as RCM Specialist II. This is a multitask position and requires the flexibility to pivot upon need of the department, provider, MSO &/or patient. Identifies problems and ensures that the information in the patient accounting system is accurate for account resolution. Demonstrates basic knowledge of accounting principles which directly impact the accounts receivable that may include debit and credit transactions; charge transfers; contractual allowances, adjustments and financial class change. Demonstrates respect and regard for the dignity of all patients, families, visitors and fellow employees to insure a professional, responsible and courteous environment.

Essential Functions

• Responsible for updating and maintaining patient accounts within medical software program to ensure accuracy of demographic and policy information.
• Scan/photocopy patients' identification, insurance cards and correspondence as appropriate.
• Processes billing calls and correspondence from patients, staff, third-party carriers, etc., in a timely manner.
• Communicates daily with internal and external customers via phone calls and written communications.
• Documents patient accounts accurately and completely

· Responsible for accurate electronic and manual posting of payments, adjustments and remittances from all payers

· Responsible for posting all payments including capitation and wrap payments appropriately

• Identify and post unapplied payments to balances as appropriate.
• Review and clear Unidentified account monthly.

· Posts zero pays, partial pays, and adjustments as indicated on payer remits

· Monitor, review and process credits from credit balance report.

· Completes and maintains daily balance and variance reports and any reporting requirements for appropriate cash handling.

· Performs in depth research when payments and/or adjustments result in a credit balance or undistributed funds.

· Interprets the explanation of benefits (EOB) and balance transfers money to the secondary insurance or patient liability.

· Must have the ability to work accurately within month end deadlines

· Coordinates with & notifies RCM team as needed for denials, underpayments, zero pays and unidentified payments.

· Assists in reconciling deposit and patient collections.

· Participates in the Performance Improvement Program.

· Works independently.

· Pursues and participates in education to remain current with changes in the Healthcare industry.

· Contributes to team effort by accomplishing related results as needed.

• Works remote with some physical presence in office for team meetings &/or special projects. Must maintain productivity standards and performance goals in order to remain in WFA environment.
• Performs other duties as assigned.

Education & Training Requirements

• High School Diploma/GED

Work Experience Requirements

• Minimum of 2 years of related experience in a medical revenue cycle environment
• Previous experience in a medical office RCM setting

Benefits

• Medical / Vision / Dental
• 9 Holiday + 1 Floating Holiday
• 403b Retirement Plan
• Paid Time Off (PTO)
  • PTO Exchange benefit

PTO Exchange will provide you with the option to convert a portion of your accrued but unused PTO hours for use toward several different benefits and causes, based on your own priorities.

With PTO Exchange, you can convert a portion of your unused PTO into:

• 403(b) Retirement contributions
• Student loan payments / Tuition for the employee
• Leave Sharing donations to fellow employees