Insurance Verifications Specialist - Full Time - Houston, TX - Cenikor Foundation

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

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. See how we served last year.
• 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. More than 25% of our total employees have been promoted the last 4 years.
• STUDENT LOAN FORGIVENESS – The Public Service Loan Forgiveness (PSLF) forgives your qualified student loans if working for a non-profit for a specific period of time. Find out more here.
• The work we do isn’t easy. If you like purposeful hard work, serving others and having FUN with your team while achieving goals, Cenikor will be the right place for you!

JOB SUMMARY:

The Verifications Specialist is responsible for providing Third Party benefits and Private Pay information; supporting all strategies of admissions, including financial verifications and client collections efforts to ensure an efficient process for those who seek treatment with Cenikor Foundation.

SCHEDULE: Monday - Friday 8a - 5p 

ESSENTIAL FUNCTIONS:

1. Provide professional, accurate, timely insurance verification of benefits and notification for all services, Detox, Inpatient, Ambulatory Detoxification, Inpatient Residential, Partial Hospitalization, Outpatient and Intensive Outpatient.
2. Responsible for knowing and following assigned plans’ guidelines, relating to In and Out of Network requirements and/or Billing Collections practices for Third Party Payors, including Medicaid, Medicare, and Insurance.
3. Ensure insurance coverage is verified via telephone or web, resolve any issues with coverage and escalate complicated issues to a supervisor or manager.
4. Calculate patient estimated portions via estimation tool and enter in the computer for front desk to collect the amount.
5. Provide effective, timely communication to client/family and/or team members about financial responsibility for insured and/or private pay clients, including setting up payments arrangements, providing proper financial forms to the facility, and/or collecting admissions payments through an online portal.
6. Work closely and communicate effectively with other corporate staff, such as access center team, insurance/billing and accounting to ensure all persons interested in admission to Cenikor are contacted within required timeframe and admissions are completed as appropriate.
7. Assist in all functions associated with Admissions including collecting client responsibility and coordinating collection of client responsibility
8. Accurately input data and maintain documentation in client files, including verification status, benefit detail and all documentation applicable to a client’s access to treatment.
9. Obtain monthly re-verifications for clients still enrolled in treatment to determine active Insurance/ Medicaid coverage.
10. Conduct general financial management of patient accounts.
11. Handle patient account inquires by researching, resolving or referring to outside collections agency, as necessary.
12. Work directly with patients to resolve past due self-pay balances, and meet deadlines and goals on a consistent basis.
13. Conduct follow up calls, prepare, review and send patient statements to maintain patient balances and/ or payment arrangements. Locate and notify insurance patients and other payors’ accounts by mail, telephone, email, and any other means necessary to solicit payment and to resolve past due self-pay balances. Utilize Transworld (TSI) to submit client statements and maintain client collections efforts.
14. Uphold the core principles of Cenikor’s culture and create a positive working environment for all team members.
15. Ensure completion of Big 5 performance management tool aby the required deadlines and use of SMART goals to support annual performance compensation review.
16. Utilize computer software to maintain schedule appointments and effectively communicate information to the appropriate party per established protocols.
17. Serve as back-up in providing coverage and/or availability for the Insurance Department for unexpected absences or projects.
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 customer service
  • Ability to be detail oriented and accurately record numerical data.
  • Possess excellent organization skills and high attention to detail
  • 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
   
• Experience:
•  Medical office or hospital registration working with insurance verifications and financial collections experience preferred.

• Certification Required:
• Medical billing and coding certification preferred.

IMPORTANT NOTES:
Drug Free Workplace
Equal Opportunity Employer