Top 263 Entry level claims Jobs in Houston Tx

Insurance Appeals Rep
PFS Group —Houston, TX
- Full-time
- Research
- Mid-level
- Organizational skills
- Disability insurance
- Health insurance
Charge Entry- Patient Accounts
Memorial Hermann Surgical Hospital Kingwood (11022) —Houston, TX
- Full-time
- Surgery
- High school diploma or GED
- Perioperative Care
Claims Examiner
Texas Children's Hospital —Houston, TX
- Full-time
- Research
- High school diploma or GED
- 1 year
Administrator I - Cash Applications
Westlake —Houston, TX
- Overtime
- Research
- Office
- High school diploma or GED
Quick Apply
Workers’ Compensation Specialist
TransPak, Inc. —Houston, TX
- $40,000 - $70,000 a year
- Full-time
- Remote
- Microsoft Excel
- Mid-level
- Bachelor's degree
Quick Apply
Field Investigator (Full-Time & Part-Time) – Houston, TX
Origin Investigations Inc —Houston, TX
- $20 - $35 an hour
- Part-time
- Background check
- Military
- Computer literacy
Quick Apply
6d
Nurse Practitioner/Physician Assistant
HUMBLE NEUROLOGY —Humble, TX
- From $60 an hour
- Part-time
- CPR Certification
- Nursing
- Certified Nurse Practitioner
Quick Apply
Dental Treatment Coordinator
Family Smiles Dental Care —Channelview, TX
- $20 - $25 an hour
- Full-time
- Private practice
- Spanish
- Dental office
- Health insurance
- Dental insurance
Quick Apply
8d
Inside Sales Representative
In-N-Out Collision —Houston, TX
- $3,000 - $8,000 a month
- Full-time
- Customer service
- In-person
- Phone etiquette
Quick Apply
Executive Underwriter - Energy Property
Zurich Insurance Company Ltd. —Houston, TX
- $79,600 - $172,400 a year
- Full-time
- Hybrid work
- Customer service
- Data analysis skills
- Mid-level
Security Officer TWIC Required - $1,000 Hiring Bonus
Allied Universal —Deer Park, TX
- $14.75 an hour
- Full-time
- 18 years or older
- 5 years
- Military
- AD&D insurance
- Paid holidays
Quick Apply
11h
Roof Salesman
Xtreme Innovation Roofing & Construction Company —Houston, TX
- $50,000 - $100,000 a year
- Contract
- No experience needed
- Residential
- Travel
- Paid training
- Flexible schedule
Quick Apply
11d
Associate Disability Attorney
Heard & Smith, LLP —Houston, TX
- Full-time
- Remote
- Writing skills
- Mid-level
- Residential
- Profit sharing
- Wellness program
11d
Junior Associate Disability Attorney
Heard & Smith, LLP —Houston, TX
- $50,000 - $65,000 a year
- Full-time
- Writing skills
- Office
- Residential
- Profit sharing
- Wellness program
11d
Health Actuary Consultant
Deloitte —Houston, TX
- $100,400 - $197,900 a year
- Full-time
- Microsoft Excel
- Up to 50% travel
- Mid-level
10d
Epic Denials Management Coordinator
Deloitte —Houston, TX
- $50,000 - $60,000 a year
- Full-time
- Microsoft Excel
- Mid-level
- Bachelor's degree
12d
HR Operations Specialist
Westlake —Houston, TX
- Full-time
- Inventory management
- Mid-level
- Office
Quick Apply
Insurance Verification Specialist (Clinic)
Premier Medical Resources —Houston, TX
- Full-time
- Background check
- Computer literacy
- Pass drug screening
- AD&D insurance
- Disability insurance
Quick Apply
Risk Analyst
Targa Resources —Houston, TX
- Office
- Bachelor's degree
- Travel
HR Specialist
Cart.com, Inc. —Houston, TX
- Full-time
- Hybrid work
- Microsoft Excel
- Mid-level
- Office
Quick Apply
6d

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entry level claims jobs near houston tx

Insurance Appeals Rep

PFS Group -
Houston, TX

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Job Details

Full-time

Benefits

Disability insurance
Health insurance
Dental insurance
Vision insurance
401(k) matching
Opportunities for advancement
Life insurance

Qualifications

Research
Medical explanation of benefits reviews
Epic
Hospital experience

Full Job Description

Insurance Appeals Representative

JOB SUMMARY

Under the supervision of the Insurance Supervisor, the Insurance Appeals Representative will work high dollar or complex denials for hospital insurance claims. The Appeals Representative will be responsible for reviewing basic clinical documentation and relevant payer guidelines to draft timely and effective appeals. They will be measured on appeals success and denials overturn rate, working to improve cash collections on behalf of their client(s). The Appeals Representative may directly write appeals or act as a consultant for other Insurance Reps, assisting them with referencing clinical or payer guidelines. They may be expected to share payer updates with Insurance teams or provide occasional information sessions to department trainer or representatives. They will prioritize work based on feedback from their leadership in order to best impact performance metrics.

ESSENTIAL FUNCTIONS

Demonstrate extensive knowledge of insurance follow-up and denials.

Act as the subject matter expert for appeals on their team.

Triage and determine denial reasons from remittance advice, explanation of benefits, payer portals, or other avenues of information.

Research pertinent payer medical policy bulletins and billing guidelines, creating a repository of reference materials for themselves and other team members.

Prioritize work effort by viability and amount of payment to maximize cash.

Track payer issues and escalations to provide relevant trending information to leadership.

Follow appeals to resolution to assess effectiveness.

Create job aids and share information on appeals language as needed.

Practice compliant billing and follow-up strategies for all government and managed care payers.

Meet minimum of 10 appeals per day, as well as any follow-up needed on existing appeals.

Aggressively seek to resolve unpaid balances.

Document all efforts accurately and thoroughly.

Follow all workflow protocols.

Work other insurance inventory as assigned or as volume demands.

Qualifications

KNOWLEDGE, SKILLS, AND ABILITIES

Outstanding research and follow-up skills.

Deep knowledge of denial types and causes.

Ability to research commercial, managed care, and government payer guidelines and reference language in all appeals.

Ability to read and interpret remittance advice/explanation of benefits.

Strong written and verbal communication skills, especially when drafting appeals or creating workflow templates for teammates.

Self-motivation and ability to work autonomously.

Basic analytics, to include Microsoft Excel.

EDUCATION AND EXPERIENCE

At least 6 months as an Insurance Representative at PFS Group, or 12 months of equivalent experience from a comparable organization.

At least 2 years of hospital insurance follow-up or denials experience.

Epic experience, with strong preference toward HB, required.

Preferences

CUBS experience

PFS Group

Nationwide Patient Account Management Firm.

Based in Houston, Texas, we currently work with 32+ clients who operate more than 100 hospital facilities from small, rural community medical centers to metro population center health systems. Leaders in their respective markets and nationwide, our clients rely on our services to support their accounts receivable departments.

PFS Group offers a friendly, caring work environment, with competitive benefits and compensation, (medical, dental, vision, short and long-term disability, life insurance, hospital indemnity, critical illness, accident insurance and a matching 401(k) and Zayzoon!

If you are looking for a position in a dynamic, fast-paced organization with career growth opportunities, come grow with us! www.pfsgroup.org

Apply Now

Refine Your Search

entry level claims jobs in houston tx

Insurance Appeals Rep

Charge Entry- Patient Accounts

Claims Examiner

Administrator I - Cash Applications

Workers’ Compensation Specialist

Field Investigator (Full-Time & Part-Time) – Houston, TX

Nurse Practitioner/Physician Assistant

Dental Treatment Coordinator

Inside Sales Representative

Executive Underwriter - Energy Property

Security Officer TWIC Required - $1,000 Hiring Bonus

Roof Salesman

Associate Disability Attorney

Junior Associate Disability Attorney

Health Actuary Consultant

Epic Denials Management Coordinator

HR Operations Specialist

Insurance Verification Specialist (Clinic)

Risk Analyst

HR Specialist

I want to receive the latest job alert for entry level claims in houston tx

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