Medical Claims Eligibility Specialist

RemX; Houston (TX); On-site; USD 28,000 - 33,000; Full time

Job summary

RemX in Houston Heights, TX is seeking a Medical Claims Eligibility Specialist to review EOBs and payment remittances, determine claim eligibility, and ensure accurate processing of inpatient and outpatient claims on a fully onsite schedule.

The ideal candidate will have experience in medical billing, collections, or insurance follow-up, strong attention to detail, and proficiency with Microsoft Office and Excel. This contract-to-hire role runs Mon-Fri, 8 AM-5 PM near the Houston Heights area.

Qualifications

• High School Diploma or GED required.
• Experience in medical billing, collections, claims processing, or insurance follow-up.
• Ability to interpret EOBs and payment remittances.
• Strong attention to detail and organizational skills.
• Proficiency with Microsoft Office and Excel.
• No Surprises Act knowledge is a plus.

Responsibilities

• Review EOBs and payment remittances to determine claim eligibility.
• Follow up on unpaid and underpaid insurance claims.
• Process in-network and out-of-network medical claims.
• Review and resubmit claims under the No Surprises Act when applicable.
• Maintain accurate claim records and documentation.
• Analyze complex claims, including HCFA 1500, UB-04, surgery, anesthesia, COB, and high-dollar claims.

Skills

Medical billing

Claims processing

Insurance follow-up

Detail oriented

Microsoft Office / Excel

Education

High School Diploma or GED

Tools

Microsoft Office

Excel

Job description

Job Description

Job Description

** Medical Claims Eligibility Specialist**

** Location: Houston Heights, TX (77018)**

** Pay: $22/hr** | Mon-Fri, 8 AM-5 PM | 100% Onsite | Contract-to-Hire

Growing healthcare organization seeking a detail-oriented professional with experience in medical billing, collections, claims processing, or insurance reimbursement.

Responsibilities

• Review EOBs and payment remittances to determine claim eligibility.
• Follow up on unpaid and underpaid insurance claims.
• Process in-network and out-of-network medical claims.
• Review and resubmit claims under the No Surprises Act when applicable.
• Maintain accurate claim records and documentation.
• Analyze complex claims, including HCFA 1500, UB-04, surgery, anesthesia, COB, and high-dollar claims.

Qualifications

• High School Diploma or GED required.
• Experience in medical billing, collections, claims processing, or insurance follow-up.
• Ability to interpret EOBs and payment remittances.
• Strong attention to detail and organizational skills.
• Proficiency with Microsoft Office and Excel.
• No Surprises Act knowledge is a plus.

Ideal Backgrounds

• Medical Biller
• Medical Collections Specialist
• Claims Specialist
• Insurance Follow-Up Representative
• Healthcare Reimbursement Specialist

** Note: Candidates should live within approximately 30 minutes of the Houston Heights area due to the fully onsite schedule.