Insurance Claims & Medical Billing Specialist

RemX; Houston (TX); On-site; USD 26,000 - 34,000; Full time

Job summary

RemX is seeking an Insurance Claims & Medical Billing Specialist in Houston, TX. This onsite contract-to-hire role focuses on reviewing insurance claims, resolving denials, and maximizing reimbursements within the revenue cycle team.

The ideal candidate has medical billing experience, claims follow-up, and knowledge of EOBs. Strong analytical skills and MS Excel proficiency are required for success in this position.

Qualifications

• Experience in reviewing EOBs, remittance advices
• Ability to read and interpret payer responses
• Strong analytical and organizational skills
• Proficient with MS Office (Excel)
• Excellent communication and follow-up abilities

Responsibilities

• Review EOBs and remittance advice to determine claim status
• Investigate and resolve denied or underpaid claims
• Follow up with insurance carriers on reimbursements
• Process in-network and out-of-network claims
• Research discrepancies and identify recovery opportunities
• Submit corrected claims and appeals as needed
• Maintain accurate claim documentation and records
• Ensure compliance with payer guidelines and No Surprises Act

Skills

Medical billing

Claims processing

EOB interpretation

Analytical skills

Education

High School Diploma or GED

Tools

Microsoft Excel

Job description

Job Description

Insurance Claims & Medical Billing Specialist

Location: Houston Heights, TX 77018
Pay: $22.00/hour- advancement opportunity
Schedule: Monday-Friday | 8:00 AM-5:00 PM
Work Environment: 100% Onsite
Position Type: Contract-to-Hire

About the Opportunity

A growing healthcare organization is seeking an experienced Insurance Claims & Medical Billing Specialist to join its revenue cycle team. This role is responsible for reviewing insurance claims, investigating payment discrepancies, resolving claim denials, and maximizing reimbursement collections.

The ideal candidate will have experience in medical billing, insurance follow-up, claims processing, healthcare accounts receivable, or revenue cycle operations.

Key Responsibilities

• Review Explanation of Benefits (EOBs) and remittance advice documents to determine claim status and payment accuracy.
• Investigate and resolve denied, underpaid, or unpaid insurance claims.
• Follow up with insurance carriers regarding reimbursement issues and claim status.
• Process both in-network and out-of-network medical claims.
• Research payment discrepancies and identify opportunities for reimbursement recovery.
• Submit corrected claims and appeals as needed.
• Maintain accurate account documentation and claim records.
• Analyze complex claims involving:
• • HCFA 1500 claims
  • UB-04 claims
  • Surgery claims
  • Anesthesia claims
  • Coordination of Benefits (COB)
  • High-dollar reimbursement claims
• Ensure compliance with payer guidelines and applicable regulations, including the No Surprises Act.
• Work collaboratively with internal departments to support timely claim resolution and payment collection.

Qualifications

Required

• High School Diploma or GED.
• Experience in medical billing, claims processing, insurance follow-up, healthcare collections, accounts receivable, or revenue cycle management.
• Ability to read and interpret EOBs, remittance advices, and insurance payer responses.
• Strong analytical, problem-solving, and organizational skills.
• Proficiency with Microsoft Office, including Excel.
• Strong communication and follow-up skills.

Preferred

• Knowledge of the No Surprises Act.
• Experience reviewing high-dollar or complex healthcare claims.
• Prior experience in hospital, physician practice, surgery center, or healthcare revenue cycle environments.

Ideal Background

Candidates with experience in the following roles are encouraged to apply:

• Medical Biller
• Insurance Follow-Up Representative
• Medical Claims Specialist
• Revenue Cycle Specialist
• Medical Collections Representative
• Healthcare Accounts Receivable Representative
• Reimbursement Specialist
• Claims Analyst
• Patient Account Representative
• Medical Billing & Collections Specialist