Senior Revenue Cycle Specialist – Claims & Denials Expert

Houstonmethodistcareers; Houston (TX); On-site; USD 60,000 - 90,000; Full time

Job summary

Houston Methodist is seeking a Revenue Cycle Specialist to provide direct and indirect support to Revenue Cycle Managers, coordinating regulatory and revenue-enhancing projects and ensuring timely completion.

The role focuses on resolving complex third-party claims, handling denials and appeals, and serving as the subject matter expert for payers while upholding HIPAA/PCI compliance and patient confidentiality.

Qualifications

• Minimum five years’ experience in commercial insurance follow-up.
• Strong understanding of payer policies and appeals.
• Proficient in communicating with patients, physicians, and payers.

Responsibilities

• Collaborates with management to target complex claims and reduce aging of accounts.
• Resolves denials and prepares appeals for Medicare, Medicaid, and commercial payers.
• Serves as the subject matter expert for payers and ensures HIPAA/PCI compliance.

Skills

Communication

Analytical skills

Customer service

Attention to HIPAA/PCI

Education

High School diploma

Associate degree preferred

Job description

Houston Methodist is seeking a Revenue Cycle Specialist to provide direct and indirect support to Revenue Cycle Managers, coordinating regulatory and revenue-enhancing projects and ensuring timely completion.

The role focuses on resolving complex third-party claims, handling denials and appeals, and serving as the subject matter expert for payers while upholding HIPAA/PCI compliance and patient confidentiality.