Medical Claims Eligibility Specialist

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.