Hospital Denials & Recovery Specialist

Addison Group; Houston (TX); On-site; USD 36,000 - 39,000; Full time

Benefits offered by this job

Medical

Dental

Vision

401k

Job summary

Addison Group in Houston, TX is seeking a Denials Specialist in a fully onsite role within a healthcare revenue cycle team. The position focuses on denial recovery for hospital UB-04 claims, NSA and out-of-network collections, and heavy payor follow-up with major commercial carriers.

The ideal candidate has 5+ years of hospital claims experience, expertise with UB-04 and denials, and strong analytical and problem-solving skills to navigate regulatory requirements and complex reimbursements.

Qualifications

• 5+ years of hospital claims experience required.
• UB-04 claims experience required.
• Extensive experience managing denials (more denial-focused than appeals) required.
• Experience with NSA and out-of-network (OON) collections required.
• Strong ability to interpret complex claim data and documentation.

Responsibilities

• Review and resolve denials related to hospital (UB-04) claims.
• Conduct detailed payor follow-up with major commercial insurance carriers.
• Investigate technical claim issues and determine next steps for resolution.
• Manage denials and appeals, with a primary focus on denial recovery.
• Handle NSA (No Surprises Act) and out-of-network (OON) collections and dispute processes.
• Analyze claim adjudication trends and identify payor behavior patterns.
• Ensure proper documentation and compliance throughout the resolution process.
• Work independently while communicating with internal stakeholders.

Skills

Denials management

Analytical thinking

EOB interpretation

Regulatory compliance

Job description

Addison Group in Houston, TX is seeking a Denials Specialist in a fully onsite role within a healthcare revenue cycle team. The position focuses on denial recovery for hospital UB-04 claims, NSA and out-of-network collections, and heavy payor follow-up with major commercial carriers.

The ideal candidate has 5+ years of hospital claims experience, expertise with UB-04 and denials, and strong analytical and problem-solving skills to navigate regulatory requirements and complex reimbursements.