Medical Collector

** MUST RESIDE IN THE HOUSTON AREA**

(Training is onsite for the first 30-45 days before transitioning to a remote role)

Position Overview

The Medical Insurance Collector is responsible for performing collection activities on complex denials, preparing appeals, and taking necessary actions on outstanding balances for BCBS, UHC, Aetna/Cigna, and self-funded/commercial providers in both the professional and facility fee environments. Our facilities are out-of-network with all payers.

To succeed in this role, candidates must possess in-depth knowledge of collection processes and medical insurance policies. The ideal candidate will also demonstrate excellent written and verbal communication skills, as they will be regularly interacting with insurance companies and customers. This position requires an individual who can multi-task, problem-solve, and manage time effectively to ensure claims are resolved promptly.

Key Responsibilities

Investigate and respond to inquiries from payers regarding insurance claims, including complex denials and appeals.

Review and correct claim errors to ensure accurate submissions and timely payment.

Follow up on unpaid claims, ensuring proper filing and resolution.

Stay updated on billing and collection policy changes for assigned payers.

Review payment errors, verify payments, and ensure accurate patient statements are issued.

Analyze Insurance Explanation of Benefits (EOBs) and initiate appeals as necessary.

Resolve payer requests and inquiries in a timely and professional manner.

Ensure compliance with the No Surprises Act and verify that payments meet qualified payment amounts.

Use critical thinking and problem-solving skills to resolve complex claim discrepancies.

Consistently meet or exceed department goals and expectations.

Job Requirements

Medical Insurance Collector: Minimum 2 years of experience in medical collections.

IDR Collectors and Settlement Specialist: Minimum 1 year of experience in medical collections.

Strong knowledge of commercial insurance providers (e.g., BCBS, UHC, Aetna/Cigna) and self-funded providers.

Proficient in understanding EOBs, HIPAA regulations, ICD-10 codes, and CPT codes.

Experience with out-of-network collections and disputes.

Familiarity with the No Surprises Act (NSA), Independent Dispute Resolution (IDR), and TDI.

Excellent written and verbal communication skills.

Strong attention to detail, time management, and multitasking abilities.

Ability to work independently and solve complex claim issues.

Nice-to-Have Skills

Experience in hospital or physician billing.

Knowledge of out-of-network collections.

Knowledge of the No Surprises Act, TDI, and IDR processes.

Selling Points

Remote Work: Potential for remote work after training (30-45 days, based on performance).

Career Growth: Opportunities for advancement into Team Lead or Supervisor positions.

Supportive Environment: Be part of a team-focused, growth-oriented company with a commitment to employee development.

Salary Range: $18–$21/hr (based on experience)

Employment Type: Contract to Hire (800 hours / 20 weeks)

Schedule: Monday - Friday, 8 AM - 5 PM