Medical Claims Specialist
7 days ago
Location: Houston, TX (Hybrid)
Industry: Healthcare Technology & Revenue Cycle Management
Pay: $20-22.50 per hour
About Our Client:
Our client is a leading provider of technology-driven revenue cycle solutions, specializing in claims bundling and value-based care models. Their platform offers payers, providers, and employers an innovative approach to managing alternative payment models. With a focus on improving decision-making and streamlining workflows, they help healthcare organizations reduce costs and enhance care quality.
Job Summary:
Addison Group is seeking a skilled CVCP Collector to join our client's team. This role is focused on managing claims submissions and collections for major payers. After initial training, the position offers a flexible hybrid work schedule.
Key Responsibilities:
- Submit and collect on professional claims (CMS 1500/837P)
- Manage claims for major payers (BC/BS, UHC, CIGNA, AETNA)
- Follow up on the status of claims and appeals
- Handle medical records requests and assist with customer service inquiries
- Communicate with payers, push back when necessary, and ensure clarity on claims
- Multi-task effectively, including managing tasks while on hold with payers
Qualifications:
- 1-3 years of healthcare collections experience, preferably in OBGYN, Radiology, or Cardiology specialties
- Experience with commercial collections or payer-side (e.g., BC/BS, UHC, CIGNA, AETNA)
- Strong written and verbal communication skills
- Familiarity with HMO, PPO, and claims management processes
- Proficient in handling multiple systems simultaneously
Additional Details:
- Training: Onsite, Monday-Friday, 8:00 AM - 5:00 PM
- Hybrid Work: After training, 3 days onsite, 2 days remote (with flexible start times)
- Compliance: Background check and drug screening required
Addison Group is an Equal Opportunity Employer. Addison Group provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, genetic information, marital status, amnesty, or status as a covered veteran in accordance with applicable federal, state and local laws. Addison Group complies with applicable state and local laws governing non-discrimination in employment in every location in which the company has facilities. Reasonable accommodation is available for qualified individuals with disabilities, upon request.
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