Medical Billing & Denials Specialist

Houston Methodist; Houston (TX); On-site; USD 42,000 - 66,000; Full time

Job summary

Houston Methodist is seeking an Account Representative to resolve outstanding third-party insurance claims for professional services and perform collections on denials and balances. You will analyze denial trends to help prevent future issues and support the revenue cycle.

Responsibilities include collaborating with internal teams, communicating with patients and physicians, and staying current with payer policies to expedite payments while maintaining HIPAA compliance.

Qualifications

• High School diploma or equivalent is required.
• Three years of physician billing experience, preferably in a multi-specialty physician practice.
• Proficiency in speaking, reading, and writing English for clear communication.
• Knowledge of CPT-4, ICD-9, ICD-10 and HCPCS coding and payer reimbursement policies.

Responsibilities

• Collaborates with management to reduce aging of accounts by providing verbal and written communication.
• Identifies denial trends and notifies supervisor to prevent future denials and delays in payments.
• Assists with knowledge sharing and cross training within the department.
• Expedites and maximizes payment of insurance claims by contacting payors and patients.

Skills

Customer service

English proficiency

Denial management

Negotiation skills

Education

High School diploma or equivalent

Job description

Houston Methodist is seeking an Account Representative to resolve outstanding third-party insurance claims for professional services and perform collections on denials and balances. You will analyze denial trends to help prevent future issues and support the revenue cycle.

Responsibilities include collaborating with internal teams, communicating with patients and physicians, and staying current with payer policies to expedite payments while maintaining HIPAA compliance.