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Insurance Eligibility Specialist

3 months ago

Houston, United States RemX Full time
Job DescriptionJob Description

Now hiring for a Insurance Eligibility Specialist in Houston, TX, 77018 (Heights Area) This position will have hours of 8-5, M-F and is contract to hire. Requires experience working in a healthcare insurance field or handling payments/appeals/denials.

Responsibilities:

  • Analyze Explanation of Benefits (EOB) and payment remittance documents submitted by healthcare providers and insurance carriers to determine which claims are eligible for the dispute resolution process.

  • Compose correspondence in accordance with regulatory requirements (and internal policies in procedures) in a clear, concise, and grammatically correct manner.

  • Communicate (via email) with healthcare providers and health plans to obtain necessary information and relay the status of all claim submissions utilizing multiple different operating systems.

  • Stay up to date on industry specific regulations, ensuring that appropriate strategies are in place.

  • Maintain physical and electronic files for all claims determined eligible.

  • These responsibilities are a condensed list of the full scope of the job description and are subject to change depending on the company’s demand.

  • Experience reviewing all types of medical claims, EOBs, and payment remittances (e.g. HCFA 1500, Outpatient/Inpatient UB92, Surgery, Anesthesia, high dollar complicated claims, COB and DRG/RCC pricing).

  • Understanding of insurance reimbursement rules.

Qualifications:

  • High School or GED
  • Meticulous and accurate
  • Detail oriented
  • Able to make quick changes and switch duties
  • MS Office Suite and intermediate Excel skills
  • Possibility for quick promotion with an increase in pay

As a RemX Insurance Specialist We Offer You:

  • Competitive pay
  • Paid weekly (Direct Deposit or ATM Debit Card available)
  • Access to health benefits and retirement plan
  • A personal recruiter to help with job searches and assistance when at work
  • Contract to Hire Opportunity

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Each and every day RemX puts over 90,000 people to work, helping more than 15,000 companies find the talent they need to succeed. And, as a part of the 10th largest staffing company in the world, we understand that at the heart of every successful business are people. That’s why we work hard to find you the right job at the right company. Explore all the exciting opportunities RemX offers and find the right job for you