Coastal Health & Wellness is Galveston County’s Community Health Center, with clinics in Texas City and Galveston. We also service TCISD students and employees. First established in 1970 and then called Galveston County Coordinated Community Clinics (4C’s), we provide high quality healthcare to all - offering primary care, prenatal, dental, and behavioral health counseling services.

RCM provides task-based coding, billing, and collection support to CHW and various Galveston County Health District (GCHD) partners. This includes standard, highly reliable, team-oriented, daily work with payors including Medicare, Medicaid, Medicaid Managed Care, Commercial Insurance as well as County Indigent and Self-pay patients in NextGen EPM/EHR/EDR.

The CHW Revenue Cycle Management Financial Counselor is a core contributor to the health & integrity of CHW’s revenue cycle performance. This team member is responsible for compliant, comprehensive, and critical work in all facets of patient accounts, credits, and collection of Accounts Receivable (A/R) for medical, dental and/or behavioral health activity. The Financial Counselor scope spans task & report-based activity including but not limited to verifying insurance, developing accurate Good Faith Estimates (GFEs), administration of out of network workflow, Advanced Beneficiary Notices (ABNs) and providing financial counseling before, during or after patient visits with CHW providers. They assist with self-pay accounts, as well as billing and collection of insurance and self-pay accounts, communicating with patients and cross-functional stakeholders on multiple platforms. The Financial Counselor works in a collaborative relationship with the CHW Patient Services team as well as other departments and employees.

We can offer you:

• Excellent Benefits; including an Amazing retirement package, Paid Time Off plans, Affordable Medical Insurance, FREE Life Insurance, FREE Long-Term Disability, FREE Parking and much more!
• Team Oriented Environment
• Hourly Rate: $20 actual offer will be commensurate upon related experience & education

We want you to join our team of professionals! If you meet the criteria listed below, please apply.

Required:

• Graduation from an accredited high school or equivalent.
• 2 years of recent experience in a medical, dental and/or behavioral health care practice performing task-based billing, insurance verification, or self-pay accounts receivable functions in an EPM system (as summarized above).
• Financial Counseling and NextGen EPM & FQHC experience preferred.
• Overall knowledge of patient registration, third party collections, verification of insurance benefits, Medicaid and other government programs, financial assistance, physician billing and/or managed care contracts is required.
• Strong team player who intentionally invests in the development of others and identifies/closes knowledge gaps.
• Capable and competent time management, multi-tasking acumen
• Excellent written & interpersonal skills.
• Bilingual in Spanish preferred.
• Understanding of medical terminology and coding & billing compliance laws, regulations, policies, and guidelines.
• Customer experience-oriented professional with demonstrated performance history and commitment.
• Advanced skills Microsoft suite of products; Outlook, MS Office (MS Excel & MS Word) – SharePoint experience a plus.
• Must be compliant with GCHD Immunizations policy and ICS training requirements.
• Must pass criminal background check and drug/alcohol screening.
• Must be willing and able to work evening and weekend hours, as necessary.
• Must possess or ability to readily obtain a valid driver’s license issued by the State of Texas for the type of vehicle or equipment operated.
• Department of Motor Vehicle check may be required, if applicable. 

An equivalent combination of education and work experience which appropriately demonstrates the knowledge, skills and abilities to perform the above described essential functions will be considered when hiring for this role.

Traditional Duties:

• Serves to help patients, especially those who are uninsured, underinsured, and have low incomes, assess, and determine a plan for resolution of their financial responsibilities. This includes establishing payment plans and other financial arrangements.
• Calculates and collects the patients’ estimated balances at pre-service or at the point of service.
• Understands CHW’s financial and discounting policies and possesses the ability to use critical thinking skills to provide the best resolution based upon the patient’s situation.
• Collaborates with other departments within CHW/GCHD and outside eligibility vendors as necessary and documents in NextGen /- Phreesia.
• Works tasks and pre-lists in NextGen to ensure patient balances are accurate.
• Exercises integrity, good judgment, and trust to ensure patient confidentiality.
• Analyzes and interprets claim reimbursement and patient account and claim-level transactions, correcting, submitting, and following-up on unpaid medical, dental, and behavioral health claims with all payors including Medicare, Medicaid, Medicaid Managed Care, and Commercial insurance companies, when required.
• Posts payments and contractual adjustments accurately based on explanation of benefits (EOBs) from payors.
• Assists with billing audit related requests.
• Processes payment transfers and refunds to payors, State of Texas, patients and/or guarantors.
• Attends all staff in-services, provider meetings, workshops, and training, lead as appropriate.
• Communicates with cross-functional, internal & external teams to identify & resolve billing and/or payment issues.
• Answers/responds to incoming calls, portal inquiries, askRCM, NextGen tasks, emails and other correspondence related to patient accounts by deploying active listening. Answers patient questions on patient responsible portions, co-pays, deductibles, write-offs, etc.
• Communicates daily with internal and external customers via phone calls, EPM/EHR tasks, patient portal, written communication, Phreesia.
• Identifies trends, and payor issues related to billing and reimbursement; report and/or escalate to RCM management.
• Performs research, documents findings, and communicates professionally, respectfully, and effectively with all stakeholders.
• Maintains patient confidentiality and protects GCHD/CHW operations by keeping patient information confidential.
• Prepares and ensures accuracy of all reports to management, consultants, payors, and other 3rd parties, as appropriate.
• Acts as a back-up to other RCM team members and actively participates in RCM projects & blitzes.
• Exercises independent judgment based on CHW Policy and compliant billing best practice.
• Perform other duties as assigned by management.

No Phone Calls Please

ADA/EEO/DFWP

Our Mission: Protecting and Promoting the One Health of Galveston County