Insurance Claims & Reimbursement Specialist

Round Table Medical Consultants Llc; Houston (TX); On-site; USD 42,000 - 62,000; Full time

Benefits offered by this job

Health benefits start on the first of月

Medical, dental, and vision plans

HSA and FSA options

Company-paid life insurance and long‑/

401(k) with company match

Employee discounts

Paid Time Off

Paid Holidays

Job summary

Round Table Medical Consultants Llc is seeking an Insurance Reimbursement Specialist to manage all insurance follow-up for maximum reimbursement. Responsibilities include outbound/inbound carrier calls, reprocessing claims, drafting appeals, handling denials, and resolving unpaid claims.

The role requires a high school diploma or GED and at least three years of experience in medical insurance follow-up, collections, denial management, and reimbursement.

Qualifications

• High school diploma or GED required.
• Minimum of three years of experience in medical insurance follow-up, collections, denial management, and reimbursement.
• Knowledge of in-network and out-of-network facility and professional claims.
• Experience working with commercial insurance carriers (e.g., UHC, Cigna, Aetna, BCBS, Marketplace plans, workers’ compensation, third-party liability).
• Proven experience preparing and submitting appeals in high-volume claims environments.
• Strong ability to read, analyze, and interpret EOBs, ERAs, payer correspondence, denial codes, and reimbursement information.

Responsibilities

• Work assigned claims accurately, efficiently, and within established timeframes.
• Research claim status, payment discrepancies, denials, coding or billing issues, and payer-specific requirements.
• Actively follow up and collect on all claims, including resolving billing errors.
• Follow all departmental policies, SOPs, compliance requirements, and leadership directives.
• Protect patient information and comply with HIPAA and confidentiality requirements.
• Meet performance goals in efficiency, accuracy, quality, and attendance.
• Perform other duties as assigned by department manager.

Skills

Insurance follow-up

Denial resolution

Appeals preparation

Analytical skills

Written and verbal communication

Negotiation

Time management

Independent work

Education

High school diploma or GED

Tools

EPOWERDOC

Centricity

Microsoft Excel

Microsoft Word

payer portals

Job description

Round Table Medical Consultants Llc is seeking an Insurance Reimbursement Specialist to manage all insurance follow-up for maximum reimbursement. Responsibilities include outbound/inbound carrier calls, reprocessing claims, drafting appeals, handling denials, and resolving unpaid claims.

The role requires a high school diploma or GED and at least three years of experience in medical insurance follow-up, collections, denial management, and reimbursement.