Insurance Billing Specialist

United Against Human Trafficking; Houston (TX); On-site; USD 42,000 - 58,000; Full time

Job summary

Cenikor is hiring an Insurance Billing Specialist to manage communications with carriers and clients to maximize payment on accounts. You will resolve denials, perform billing tasks accurately, and support admissions and accounting teams to ensure timely cash flow.

The role requires 1–3 years of billing experience, proficiency in Microsoft Office, and strong organization and communication skills. This is a non-remote, on-site position with standard Monday–Friday hours.

Qualifications

• One to three years insurance billing experience required.
• Medical billing and coding certification preferred.
• Proficient in Microsoft Office and ten-key data entry.

Responsibilities

• Process and submit clean claims to Third Party Payors electronically or by paper.
• Communicate with carriers, payors, clients and facilities to maximize payments.
• Review and appeal denials and manage refunds for overpayments.
• Input data accurately and maintain client account documentation.
• Coordinate with Admissions and Business Manager on client responsibilities.

Skills

Insurance billing

Coding

Administrative procedures

Microsoft Office

Ten-key

Organization

Communication

Teamwork

Education

High School Diploma or GED

Tools

Microsoft Office

Outlook calendar

Job description

Cenikor's Value Proposition - What's In It for You

• PURPOSE in your work - service to others, giving back to your community, helping to save lives, being fulfilled at work.
• COMPETITIVE PAY, BENEFITS, PAID TIME OFF, $2k - $4k TUITION REIMBURSEMENT, up to 10% 401K and BONUSES - we hire and reward high performers.
• STABILITY and GROWTH - more than 55 years in business - our strong financial processes support our drive to serve more people and ensure stability for our team members.
• CONTINUOUS LEARNING and PROFESSIONAL DEVELOPMENT - we are committed to developing our leaders in their desired career path and promoting from within. We have Cenikor Career Pathways Program that you can join after 90 days of employment. We also have an annual leadership development program with assigned mentors to help you achieve your professional goals.
• The work we do isn't easy. If you like to work hard, to serve others and to have FUN with your team while achieving goals, Cenikor will be the right place for you!

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: 8-5pm

ESSENTIAL FUNCTIONS

1. 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.
2. 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.
3. Ensure insurance coverage via telephone or web resolves any issues with coverage and escalates complex issues to a supervisor or manager.
4. 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.
5. 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.
6. Assist in all functions associated with Admissions including collecting client responsibility and coordinating with Business Manager and Accounting Assistant.
7. Prepare and submit clean claims to various Third Party Payors electronically and/or paper submission.
8. Ensure standard codes are accurately assigned to clients' medical information for insurance reimbursement purposes.
9. Perform various inquiries and collection actions regarding reimbursements/payments from Third Party Payors by phone or web.
10. Answer phone calls from clients regarding accounts and contact clients regarding outstanding account balances for services.
11. Assist in setup of payment plans if the client cannot pay in full at the time the bill is received.
12. Accurately input data and maintain documentation in client files, including any invoices and payments.
13. Analyze, work, and appeal denials from EOB's and correspondence daily. Flag accounts appropriately.
14. Review EOB's and download all electronic remittances and ensure that allowances, adjustments, unallocated payments and overpayments are posted correctly.
15. Initiate and work up refund requests for overpayments.
16. Uphold the core principles of Cenikor's culture and create a positive working environment for all team members.
17. Maintain strict confidentiality on all client and foundation matters and refer questionable issues to supervisor.
18. 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 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 required

Experience

• One to three years insurance billing experience required.

Certification Required

• Medical billing and coding certification preferred.

IMPORTANT NOTES

Drug Free Workplace

Equal Opportunity Employer