This position is hybrid in Houston, TX (Office: 2929 Allen Parkway, Houston, Tx 77019)

Be a part of driving healthy change in our communities

About the Position

RCM Specialist I will work in a corroborative, team environment by establishing strong working relationships with department, MSO, patients, payors, providers and clinic staff. The representative must also display strong detailed oriented skills with the proven ability to multitask. Insurance and medical terminology will be used daily. Basic knowledge of insurance carrier guidelines is required. Demonstrates respect and regard for the dignity of all patients, families, visitors and fellow employees to insure a professional, responsible and courteous environment.

Key Responsibilities

• Assesses accuracy of demographic and policy information within patient accounts and updates as needed
• Scan/photocopy patients' identification, insurance cards and correspondence as appropriate.
• Responds to correspondence and phone calls related to patient accounts and is available to answer billing and charge related inquires by patients, staff, managed care organizations, etc., in a timely manner.
• Communicates daily with internal and external customers via phone calls and written communications.
• Documents all communication and transactions in patient accounts accurately and completely
• Assists in patient collections and reconciling deposit.
• Responsible for verification of patient insurance eligibility and authorization requirements daily.
• Determine individual insurance plan benefits for scheduled exams/testing for all service types.
• Obtain any required clinical history from referring physician in order to obtain authorization.
• Adheres to Documentation Guidelines pertaining to all eligibility, authorization, and determination of benefits information
• Communicate with patients and/or referring physicians on non-covered benefits or exam coverage issues.
• Communicate with patients and front office team on patient financial responsibility.
• Provide guidance to Clinic Staff, Scheduling Staff, and other appropriate Departments regarding Authorization and Eligibility.
• Stay informed; establish method and communicate any updates and/or changes in Payor authorization processes and requirements.
• Works independently.
• 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.
• Communicates with Leads to identify and resolve all RCM issues.
• 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.

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 equivalent.
• External Candidates: 1-2 years of related medical revenue cycle experience is required.
• Internal Legacy Candidates: 3 years of patient facing or clinic experience is required. Patient Facing/Clinic experience is defined as work experience at Legacy as a Front Desk Clerk, Medical Assistant, Care Team Assistant, Eligibility Specialist, and/or Referral Specialist.

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.