Job Opening: Eligibility Specialist

Now hiring for a COI/Eligibiity Specialist II in Houston, TX, 77018 (Heights Area) – Contract to Hire – This position is fully in office and will have hours of 8-5, M-F.

Requires experience with Medical Insurance Collections, Claims Billing or No Surprise Act.

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.

Collections from insurance carriers

Billing for in and out of network claims

Re-submittal of No Surprises Act Claims

Maintain physical and electronic files for all claims determined eligible.

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.

Remote but will require an occasional in office meeting

Qualifications:

High School or GED

Meticulous and accurate

Billing/Collections experience

No Surprises Act – Preferred

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