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Enrollment / Eligibility Specialist
Portland, TX

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Coastal Plains Integrated Health

Reimbursement Specialist

Job Description

Job Summary We are seeking a dedicated Reimbursement Specialist to join our dynamic team in Portland Tx. Responsibilities This position performs complex reimbursement work that involve billing, payments, and appeals for Medicaid, Medicare, Third party payers and consumers.
Specifically:
  • Reviewing, posting insurance payments, write offs, and denials in the billing system.
  • Distributing reports to clinical staff
  • Verifying patient insurance status. Entering insurance information in billing system.
  • Compiling, sorting, and verifying accuracy of data to be entered (service logs, financial assessments, insurance information) Obtaining further information for incomplete/erroneous documentation
  • Acquires insurance authorizations for services.
  • Reviews and resolves problems related to EVV billing Assists the billing department with
  • Credentialing applications for enrollment with insurance companies.
  • Configuring the billing system to accommodate changes
  • Generating and shipping insurance claims
  • Analyzing and reporting barriers to collections.
  • Training of staff in the financial assessment process.
  • Prepares financial reports for management.
Works under the supervision of the Director of Authority Functions with some degree of latitude for the use of initiative and independent judgment.
MINIMUM QUALIFICATIONS
A Bachelor's degree from an accredited college or university with a major in a field related to the position, plus four years' experience relevant to the duties to be performed.
PREFERRED REQUIREMENTS
1. Excellent problem-solving skills 2. Knowledge/experience with Texas Medicaid and/or private insurance billing 3. Knowledge of HCS; Texas Home Living; Card, Mental Health Rehabilitation and Case Management service; SUD; and primary care service provision. 4. Excellent good computer skills 5. Ability to learn, understand and apply increasingly complex operational procedures and perform detail work rapidly and accurately. 6. Ability to maintain a Class C license with less than ten (10) penalty points
Pay:
$4,302.00 per month
Benefits:
401(k) 401(k) matching Dental insurance Employee assistance program Health insurance Life insurance Paid time off Retirement plan Vision insurance
Work Location:
In person