Summary

This position will act as an additonal resource to four Full - Time Employee (FTE) billing staff and clinic providers. This position will assist with the overall day to day billing functions of the clinic. Most importantly the position will play a key part to ensure the clinic system is appropriately billing payers to insure reimbursements are maximized.  Will have overall responsibility and accountability for the revenue cycle process of the eight clinic system, from provider documentation and coding to payer reimbursements.  Will manage and report on accounts receivable activity.  Will also identify lost revenue and process gaps.

The Baylor Teen Health Clinic currently provides pregnancy testing, family planning, sexually transmitted diseases (STD) and HIV/AIDS education and screening, primary healthcare, and case management services to teens, their partners, and adolescents in Harris County. The clinics provide services to teens from the age of 13-24.

Services We Provide:

• Comprehensive Exams (Male & Female).
• Gynecological services.
• Birth control and family planning.
• Sexually transmitted disease screening and treatment.
• Primary healthcare.
• Immunizations.
• HIV/AIDS education and screening.

Job Duties

• Assists with managing the overall day to day billing process of the eight clinic system, from provider documentation and coding to payer reimbursements.
• Through follow up of billed claims, manages the process of validating payment accuracy from payers, including State Grants. This includes identify and presenting solutions to trends that negatively affect reimbursment, as well as internal payor payment issues that may need scaled to payors Provider Representatives.
• Takes initiative to become a sudject matter expert for billing of services provided, as well as identify billing process improvement opportunities and taking on special projects that may take research and additonal time to resolve. Communicate and prioritize findings/special projects, and see them through to completion.
• Serves as a resource for clinic employees/providers by providing education and training to insure reimbursements can be maximized.
• Performs other duties as assigned.

Minimum Qualifications

• High school diploma or GED.
• Three years of relevant experience.

Preferred Qualifications

• Experience working with the State of Texas Healthy Texas Women or Family Planning Programs.
• Experience in federal, state and managed care reimbursement processing.
• Experience with HHSC and TMHP.
• Keen analytical, problem solving and organizational skills.
• Knowledge of HIPAA and all applicable regulatory rules and regulations.