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Job description
Insurance Billing SpecialistCenikor is a non-profit organization and one of the largest substance abuse treatment centers in the nation. We are currently seeking an Insurance Billing Specialist for our Corporate office in the Memorial area of Houston, TX.JOB SUMMARY: The Insurance Billing Specialist is responsible for communication with carriers, payors, clients, facilities and management at all levels to get maximum payment on accounts. Identify and resolve issues or changes to achieve client profitability, as well as complete resolution on denials.SCHEDULE: Monday - Friday: 8-2pmESSENTIAL FUNCTIONS:Responsible for knowing and following assigned plans' guidelines, pre-certification requirements and procedures for filing and appealing claims of Third Party Payors, including Medicaid, Medicare, and Insurance.Interact regularly with insurance carriers to provide accurate information, allowing the carrier to make an informed determination of a patient's coverage, eligibility, and calculate any patient financial responsibilities.Ensure insurance coverage via telephone or web resolves any issues with coverage and escalates complex issues to a supervisor or manager.Provide effective communication to client/family, team members and other health care staff in regards to benefits, appointment scheduling, client responsibility via email or other means; provide proper forms for financial responsibility, self pay clients, payments arrangements and admissions payments.Work closely and communicate effectively with access center team to ensure all persons interested in admission to Cenikor are contacted within required timeframe and admissions are completed as appropriate. Complete any required documentation and report for access center.Assist in all functions associated with Admissions including collecting client responsibility and coordinating with Business Manager and Accounting Assistant.Prepare and submit clean claims to various Third Party Payors electronically and/or paper submission.Ensure standard codes are accurately assigned to clients' medical information for insurance reimbursement purposes.Perform various inquiries and collection actions regarding reimbursements/payments from Third Party Payors by phone or web.Answer phone calls from clients regarding accounts and contact clients regarding outstanding account balances for services.Assist in setup of payment plans if the client cannot pay in full at the time the bill is received.Accurately input data and maintain documentation in client files, including any invoices and payments.Analyze, work, and appeal denials from EOB's and correspondence daily. Flag accounts appropriately.Review EOB's and download all electronic remittances and ensure that allowances, adjustments, unallocated payments and overpayments are posted correctly.Initiate and work up refund requests for overpayments.Uphold the core principles of Cenikor's culture and create a positive working environment for all team members.Maintain strict confidentiality on all client and foundation matters and refer questionable issues to supervisor.Perform additional duties as assigned and consistent with the non-exempt functions as defined in this job description.QUALIFICATIONS FOR THE POSITION: Skills, Knowledge and Abilities:Skilled in insurance billing coding and processing.Skilled in administrative and clerical procedures.Skilled in Microsoft Office and ten-key.Ability to possess excellent organization and communication skills.Ability to be detail oriented and accurately record numerical data.Ability to possess a "can-do" attitude.Ability to work in a team environment.Knowledge of Microsoft Office software required, including specific MS Outlook calendar experience.Ability to consistently uphold the Core Principles of Cenikor's Culture:Demonstrate mission of service to our clientsPositive, respectful communication with both staff and clientsDemonstrate self-motivation and perseverance to achieve goalsRole model appropriate, professional behaviors including appropriate client boundariesWork effectively as part of a team, helping to set up others for successEducation:High School Diploma or GED requiredExperience:One to three years insurance billing experience required.Certification Required:Medical billing and coding certification preferred.IMPORTANT NOTES:Drug Free WorkplaceEqual Opportunity Employer
Worksite address
houston, TX, 77001, US
Who can apply
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