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Legacy Community Health Services: Eligibility Specialist Lead

Legacy Community Health Services

This is a Full-time position in Houston, TX posted September 1, 2021.

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 10 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.Job DescriptionThe Eligibility Specialist Lead determines applicant eligibility for third party reimbursement, processes data necessary for admission of new patients into health services, ensure proper coding for insurance billing, and handle inquiries from prospective applicants and patients.

Acts as support for both team members and Management.Essential FunctionsConducts eligibility for clients following procedures and guidelines specific to each program.Confirm any additional client’s payer source such as Medicaid, Medicare, ADAP, and any other third party insurance.Register clients into the CPCDMS and manages record owner transfers when and if needed.Complete all necessary paperwork and performs data entry to eligible clients into electronic system.Maintains up-to-date and orderly eligibility files.Conducts renewal eligibility as required by each program.Confirms eligibility appointments with clients and sets initial service appointments once eligibility has been determined.Provides clients with list of required eligibility documentation.Participates in the Performance Improvement Program.Assist clients with Marketplace.Demonstrates respect for the dignity of all patients, families, visitors and fellow employees to insure a professional, responsible and courteous environment.Eligibility Specialist Lead will be first-line contact in manager’s absence regarding Eligibility situations.Monitors multiple clinic schedules on a daily basis.Completes Site visits to multiple clinic locations to manage and assist the Eligibility Department when needed.Participates in external, internal, quarterly and yearly audits.Hosts newly hired departmental employees’ Training Class and assists with the learning process.Assists Management with multiple reports, based on program specific needs.Assists with other projects, as needed.Promotes effective working relations and works effectively as part of a team to facilitate the department’s ability to meet its goals and objectives.Attends all required safety training programs and can describe his/her responsibilities related to general safety, department/service safety, specific job–related hazards.Attends all required safety education programs.Operates assigned equipment and performs all procedures in a safe manner as instructed.Maintains work area and equipment in condition required by Legacy standards.Demonstrates proper body mechanics in all functions.Checks on the patient’s environment and equipment to insure safety.

Reports safety concerns promptly to appropriate personnel.Follows Legacy’s exposure control plans/blood borne and airborne pathogens.Demonstrates knowledge of techniques, procedures and correct use of protective barrier equipment (Universal Precautions).Assures a safe environment by instituting appropriate control measures.Attends annual education programs.Education & Training RequirementsHigh School Diploma or GED, some medical knowledge.Bilingual preferredWork ExperienceA minimum of 3-5 years of medical billing experience preferred.Some training or background in ICD-A / CPT codes preferred.Ability to understand and practice bookkeeping and accounting terminology required.Knowledge of medical terminology and billing practices preferred.Ability to operate computers and other office machines required.Must be able to take responsibility and work under pressureBenefits9 Holiday + 1 Floating HolidayPTO403b Retirement PlanMedical / Vision / Dental (if eligible)

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