Job Description
Job DescriptionWe are looking for a detail-oriented Medical Billing/Claims/Collections specialist to support revenue cycle activities for a healthcare team in Texas. This Long-term Contract position is ideal for someone who can stay productive during extended payer wait times, confidently work through insurance procedures, and pursue accurate claim resolution. The person in this role will combine strong follow-up skills with hands-on portal work to keep appeals, reconsiderations, and collections activity moving efficiently.
Responsibilities:
• Manage outstanding insurance claims and account balances by contacting payers, researching issues, and driving timely resolution of unpaid or underpaid accounts.
• Use payer portals, including Availity, to submit appeals, upload supporting documentation, and process reconsideration requests while balancing multiple tasks throughout the day.
• Review explanations of benefits and claim outcomes to identify denials, payment discrepancies, and follow-up actions needed for hospital billing accounts.
• Maintain productivity during lengthy payer calls by organizing account work, documenting updates clearly, and advancing other claim-related tasks when possible.
• Navigate complex insurance processes to reach appropriate payer representatives and obtain accurate guidance aligned with federal program requirements.
• Analyze aging reports and medical accounts receivable activity to prioritize follow-up efforts and improve recovery on outstanding balances.
• Support denial management by investigating root causes, preparing appeal submissions, and tracking responses through final determination.
• Record collection activity, payer communication, and account status updates thoroughly to ensure accurate billing records and continuity of follow-up.• Prior experience in medical billing, medical claims follow-up, or healthcare collections.
• Working knowledge of medical accounts receivable concepts, including aging buckets and reimbursement follow-up.
• Ability to interpret explanations of benefits and identify denial reasons, payment variances, and next steps.
• Experience handling medical denials, appeals, and reconsiderations with commercial or government payers.
• Familiarity with hospital billing workflows and payer portal tools such as Availity.
• Strong multitasking skills with the ability to remain organized and productive during extended payer hold times.
• Clear written and verbal communication skills for payer outreach, documentation, and claim escalation.