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Accounts Receivables - Insurance Follow Up - Houston, TX

Cenikor Foundation is a non-profit organization and one of the largest substance abuse treatment centers in the nation. We are currently seeking a Collections Specialist in our corporate office located in Houston, TX.

JOB SUMMARY:

The Accounts Receivables - Insurance Follow Up 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 a complete resolution on denials.   

ESSENTIAL FUNCTIONS:

  1. Conduct general financial management of patient accounts.
  2. Review coding information for procedures performed and diagnosis on the charge, comparing to payor specific coding rules.
  3. Research, analyze and resolve outstanding customer/insurance balances to ensure claims payment.
  4. Work and communicate with managers and all insurance staff in regards to claims billing changes or trends.
  5. Appeal and resolve outstanding claims resulting from denials, wrong insurance, etc.; escalate appeals to all available insurance companies.
  6. A/R collection efforts, file proof of claims and handle legal/ TDI correspondence.
  7. Post insurance & patient payments accurately and assist manager in resolving disputes.
  8. Handle patient account inquires by researching, resolving or referring to the manager.
  9. Work directly with patients to resolve past due self-pay balances, and meet deadlines and goals on a consistent basis.
  10. Conduct follow up calls to maintain patient balances and/ or payment arrangements; locate and notify insurance patients and other payers’ accounts by mail, telephone, email, and any other means necessary to solicit payment.
  11. Review and document work performed/action taken on AR Aging Report amounts on the over/under payment report; contacts payer or patient as appropriate.
  12. Maintain fax logs, phone logs for insurance reference.
  13. Audit contractual adjustments and ensure that the approval process for adjustments is followed.
  14. Prepare, review and send patient statements.
  15. Uphold the core principles of Cenikor’s culture and create a positive working environment for all team members.  Be able to effectively communicate the core principles of Cenikor’s culture to candidates during interview process.
  16. 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:

  1. Knowledge of medical billing, coding and collections.
  2. Skilled in customer service
  3. Excellent listening and phone skills
  4. Fast problem solver and able to multi-task
  5. Possess excellent organization skills and high attention to detail
  6. Ability to work in a team environment
  7. Knowledge of Microsoft Office software required, including specific MS Outlook calendar experience.
  8. Ability to consistently uphold the Core Principles of Cenikor’s Culture:
  • Demonstrate mission of service to our clients
  • Positive, respectful communication with both staff and clients
  • Demonstrate self-motivation and perseverance to achieve goals
  • Role model appropriate, professional behaviors including appropriate client boundaries
  • Work effectively as part of a team, helping to set up others for success

 

Education:

  • High School Diploma or GED

Experience:

  • One to three years insurance billing/collections experience required.

Certification Required:

  • Medical billing and coding certification preferred.

IMPORTANT NOTES:

DRUG FREE WORKPLACE

EQUAL OPPORTUNITY EMPLOYER

 

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