Collections & AR Specialist - Multi-Office Mental Health Practice

Strive Rehabilitation Partners; Houston (TX); On-site; USD 32,000 - 39,000; Full time

Job summary

Strive Rehabilitation Partners seeks an experienced Insurance Collections & Appeals Specialist to maximize reimbursement through proactive AR follow-up, denial resolution, and payer communication. This role requires navigating payer requirements and independently managing a portfolio of outstanding receivables in a Houston-based office.

The ideal candidate has 3+ years in medical insurance collections, strong knowledge of Medicare/ commercial billing, and proven ability to resolve complex claims

Qualifications

• Minimum 3 years of experience in medical insurance collections, AR follow-up, denial management, or appeals.
• Demonstrated experience resolving complex unpaid and denied medical insurance claims.
• Strong working knowledge of commercial insurance reimbursement and Medicare billing requirements.
• Experience with professional medical billing, CMS-1500, CPT codes, ICD-10, modifiers, and EOB analysis.
• Ability to interpret remittance advice, adjustment reason codes, and payer denial explanations.
• Experience preparing written appeals, reconsideration requests, or formal payer disputes.
• Proficiency with medical billing or practice management software and online payer portals.
• Strong organizational skills and ability to manage multiple accounts, deadlines, and follow-up priorities.
• Excellent written and verbal communication skills with insurance representatives.
• Ability to investigate problems independently and follow claims through to final resolution.
• Working knowledge of HIPAA requirements and confidential patient information handling.
• Ability to work full-time, on-site at our Houston office.

Responsibilities

• Manage assigned insurance accounts receivable balances, prioritizing aged, high-dollar, and at-risk claims.
• Follow up with Medicare, Medicare Advantage, Medicaid, and commercial payers.
• Investigate unpaid, partially paid, rejected, and underpaid claims to determine resolution.
• Research claim status, payment discrepancies, and reimbursement issues using payer portals and practice management systems.
• Identify and resolve claim processing errors, COB issues, authorization discrepancies, and payment barriers.
• Monitor timely filing deadlines, reconsideration windows, and appeal requirements.
• Maintain accurate documentation of collection activity and next steps.
• Escalate systemic reimbursement issues and high-risk accounts to management.

Skills

Analytical thinking

Persistent

Organizational skills

Communication skills

Independent problem solving

Tools

AdvancedMD

Waystar

Job description

Position Summary

The Insurance Collections & Appeals Specialist is responsible for maximizing insurance reimbursement through proactive accounts receivable follow-up, denial resolution, appeals, and payer communication.

This position requires an experienced revenue cycle professional who understands medical insurance billing, can independently investigate complex reimbursement issues, and knows how to navigate payer requirements to secure payment.

The ideal candidate is analytical, persistent, organized, and comfortable challenging incorrect payer determinations. Experience with behavioral health billing, professional medical claims, and Medicare reimbursement is particularly valuable.

This is not an entry-level billing position. We are looking for someone who can independently manage a portfolio of outstanding receivables, identify barriers to payment, and consistently produce measurable collection results.

Key Responsibilities

Insurance Collections & Accounts Receivable Management

• Manage assigned insurance accounts receivable balances, prioritizing aged, high-dollar, and otherwise at-risk claims.
• Conduct proactive follow-up with Medicare, Medicare Advantage, Medicaid, and commercial insurance payers.
• Investigate unpaid, partially paid, rejected, and underpaid claims to determine the appropriate resolution.
• Research claim status, payment discrepancies, and reimbursement issues using payer portals, practice management systems, and direct payer communication.
• Identify and resolve claim processing errors, missing documentation, coordination-of-benefits issues, authorization discrepancies, and other payment barriers.
• Monitor timely filing deadlines, reconsideration windows, and appeal requirements to protect reimbursement opportunities.
• Maintain accurate documentation of collection activity, payer communications, and next steps.
• Escalate systemic reimbursement issues and high-risk accounts to management as appropriate.

Denial Management & Appeals

• Analyze claim denials and identify the underlying causes of nonpayment.
• Prepare, submit, and track first-level and subsequent appeals, including supporting documentation and written medical reimbursement arguments.
• Challenge inappropriate denials, incorrect contractual adjustments, and reimbursement determinations inconsistent with payer requirements.
• Research payer medical policies, reimbursement guidelines, coverage requirements, and applicable Medicare regulations.
• Work with clinical and administrative personnel to obtain medical records and other documentation necessary to support appeals.
• Track appeal outcomes and follow through until claims are appropriately resolved.
• Identify recurring denial patterns and recommend corrective actions to prevent future revenue loss.

Revenue Cycle Analysis & Process Improvement

• Review aging reports, denial trends, collection performance, and payer-specific reimbursement issues.
• Identify opportunities to accelerate cash collections and reduce outstanding A/R.
• Collaborate with billing, credentialing, and clinical personnel to resolve issues affecting claim payment.
• Assist in identifying payer enrollment, provider credentialing, or contracting issues contributing to reimbursement delays.
• Recommend improvements to billing workflows, claim submission practices, and denial prevention processes.
• Provide regular updates on collection activity, unresolved accounts, appeal status, and recovery results.
• Support special projects involving aged receivables, payer reconciliations, and revenue recovery initiatives.

Required Qualifications

• Minimum 3 years of experience in medical insurance collections, accounts receivable follow-up, denial management, or appeals.
• Demonstrated experience resolving complex unpaid and denied medical insurance claims.
• Strong working knowledge of commercial insurance reimbursement and Medicare billing requirements.
• Experience with professional medical billing, including CMS-1500 claims, CPT codes, ICD-10 diagnosis codes, modifiers, and explanation-of-benefits analysis.
• Ability to interpret remittance advice, adjustment reason codes, and payer denial explanations.
• Experience preparing written appeals, reconsideration requests, or formal payer disputes.
• Proficiency with medical billing or practice management software and online payer portals.
• Strong organizational skills and ability to manage multiple accounts, deadlines, and follow-up priorities.
• Excellent written and verbal communication skills, including professional but assertive communication with insurance representatives.
• Ability to investigate problems independently and follow claims through to final resolution.
• Working knowledge of HIPAA requirements and confidential patient information handling.
• Ability to work full-time, on-site at our Houston office.

Preferred Qualifications

• Experience with behavioral health, mental health, psychology, psychiatry, or rehabilitation medicine billing.
• Experience with Medicare Part B and physician or other professional-service reimbursement.
• Familiarity with behavioral health CPT codes and payer-specific coverage policies.
• Experience with hospital-based physician practices or multi-provider medical groups.
• Experience using AdvancedMD practice management software.
• Experience with Waystar or other electronic claims clearinghouses.
• Experience identifying contractual underpayments and pursuing reimbursement corrections.
• Familiarity with Medicare appeals processes and commercial payer escalation procedures.
• Demonstrated success reducing aged A/R or recovering previously denied insurance balances.

What Success Looks Like

A successful Insurance Collections & Appeals Specialist will:

• Consistently recover outstanding insurance balances through effective follow-up and appeals.
• Reduce aged accounts receivable and prevent claims from exceeding filing or appeal deadlines.
• Independently identify and resolve complex payment issues.
• Maintain clear, accurate, and timely documentation of collection efforts.
• Recognize recurring payer problems and help prevent future denials.
• Work collaboratively with management and other team members to improve overall revenue cycle performance.
• Demonstrate ownership of assigned accounts and persistence in pursuing appropriate reimbursement.

Compensation & Work Environment

• Pay: $23.00–$28.00 per hour, based on relevant experience and qualifications.
• Employment Status: Full-time, hourly.
• Location: Houston, TX 77063.
• Work Arrangement: 100% on-site. This position is not remote or hybrid.
• Schedule: Monday–Friday, standard business hours.
• Benefits: Details provided during the hiring process.

Why Join Strive?

Strive Rehabilitation Partners offers the opportunity to work within a growing, specialized healthcare organization where individual contributions have a direct impact on operational performance.

Unlike high-volume billing environments where specialists are limited to repetitive claim-status inquiries, this position offers meaningful responsibility for investigating reimbursement problems, pursuing appeals, and recovering revenue.

We value professionals who take initiative, exercise sound judgment, and are willing to pursue difficult claims through resolution.

If you have a strong background in medical insurance collections and appeals, enjoy solving challenging reimbursement problems, and take pride in producing measurable results, we encourage you to apply.

Strive Rehabilitation Partners is an Equal Opportunity Employer. We consider qualified applicants without regard to race, color, religion, sex, national origin, age, disability, veteran status, or any other characteristic protected by applicable law.