Job Description

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

JOB SUMMARY:

The Payment Applications Specialist is responsible for the timely and accurate posting of payments, denials and adjustments from all financial entities and Third Party Payors.

SCHEDULE: MONDAY - FRIDAY 8A - 5P

ESSENTIAL FUNCTIONS:

1. Accurately read, interpret, and post the explanation of benefits (EOB) from different insurance payers and post payments to patient encounters with minimal or no error rate into Cenikor’s electronic systems, as applicable on a daily basis.
2. Accurately post patient check or credit card payments to the patient account.
3. Post insurance & patient payments accurately and assist manager in resolving disputes.
4. Adhere closely to the department's payment reconciliation process to include reconciling all payment transactions via the Practice Management System and the daily posting of these batches. Report any payment variances to their immediate manager and/or supervisor for prompt resolution, and work with accounting to ensure timely resolution.
5. Post all denied charges for collections department utilizing proper denial causes and reporting denial data permitting timely resolution.
6. Research and resolve payment inquiries from revenue cycle team members, and manage all un-applied payments.
7. Work and communicate with managers and all insurance staff in regards to denied charges, rejected claims or any other issues that affect reimbursement.
8. Document additional necessary information for explanation of benefits (EOB) clear and accurate manner to insure others can follow documentation.
9. Verify payments posted against totals on bank statement by performing daily and weekly reconciliation.
10. Audit contractual adjustments and ensure that the approval process for adjustments is followed.
11. Maintain an error rate in accordance with departmental policy.
12. Meet or exceed productivity standards in the completion of daily assignments and accurate production.
13. Collaborate with teammates to ensure that our departmental close for each month is met within guidelines supporting financial success of the foundation for each month.
14. Understand external rules and regulations as they relate to healthcare billing and collections e.g. Medicare, Medicaid, state laws, Health Insurance Portability and Accountability Act (HIPAA), etc.
15. Uphold the core principles of Cenikor’s culture and create a positive working environment for all team members.
16. Maintain the strictest confidentiality; adhere to all HIPAA guidelines/regulations.
17. 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:
  • Possess excellent organization skills and high attention to detail
  • Knowledge of medical billing, coding and collections.
  • Excellent verbal, listening, and written communication skills
  • Fast problem solver and able to multi-task
  • High degree of tact and discretion
  • Ability to work in a team environment
  • Knowledge of Microsoft Office software required, including specific MS Outlook calendar and Excel 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 or medical collections experience preferred.
  • Thorough knowledge of financial and accounting procedures preferred.
  • Intermediate Microsoft Excel experience required
• CERTIFICATION REQUIRED:
  • Medical billing and coding certification preferred.

IMPORTANT NOTES:

EQUAL OPPORTUNITY EMPLOYER

DRUG FREE WORKPLACE

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