Healthcare Claims Collections & Denials Specialist

Altus Emergency; Houston (TX); On-site; USD 45,000 - 65,000; Full time

Job summary

Altus Emergency is seeking a Collections Specialist to drive timely resolution of denied and underpaid insurance claims, including filing, reviewing, and following through to payment. You will analyze provider records, explanations of benefits, and remits to secure payments and submit appeals.

You will investigate denials, underpayments, and apply root-cause fixes while supporting IDR filings for out-of-network claims and contributing to training and process improvements within the Revenue Cycle

Qualifications

• Experience in collections and denials management in a healthcare setting.
• Ability to analyze data trends and make data-driven decisions.
• Strong communication and interpersonal skills in a fast-paced environment.

Responsibilities

• Monitor daily claims volume and deadlines, ensuring timely follow-up.
• Work payer denials, underpayments, and rejected claims to resolution.
• Investigate and correct claims denied or paid in error and prevent recurrence.
• Verify EOBs for accurate posting and resolve posting issues.
• Coordinate negotiations, mediations, and arbitrations for denials and IDR filings.
• Produce weekly/monthly reports on trends, unposted payments, and training needs.

Skills

Collections

Denials management

IDR negotiations

Data analysis

Billing & coding

Communication skills

Tools

Healthcare IT systems

Job description

Altus Emergency is seeking a Collections Specialist to drive timely resolution of denied and underpaid insurance claims, including filing, reviewing, and following through to payment. You will analyze provider records, explanations of benefits, and remits to secure payments and submit appeals.

You will investigate denials, underpayments, and apply root-cause fixes while supporting IDR filings for out-of-network claims and contributing to training and process improvements within the Revenue Cycle