Top 146 Billing representative Jobs in Sugar Land, Tx

Insurance Appeals Rep
PFS Group —Houston, TX
- Full-time
- Research
- Mid-level
- Organizational skills
- Disability insurance
- Health insurance
12d
Remote Insurance Rep
PFS Group —Houston, TX
- Full-time
- Remote
- Microsoft Excel
- Microsoft Outlook
- Writing skills
- Disability insurance
- Health insurance
Insurance Follow-Up Representative III - Kelsey Seybold Clinic - Pearland - Hybrid
Optum —Pearland, TX
- $20 - $36 an hour
- Full-time
- Hybrid work
- Computer literacy
- Pass drug screening
- Research
Quick Apply
5d
Collections Representative - Kelsey Seybold - Pearland
Optum —Pearland, TX
- $18 - $32 an hour
- Full-time
- Microsoft Word
- Microsoft Excel
- Computer literacy
Quick Apply
5d
Business Office Coordinator
The Harris Center for Mental Health and IDD —Houston, TX
- From $20.28 an hour
- Full-time
- Spanish
- English
- Mid-level
- Paid time off
- Employee assistance program
6d
Revenue Representative – Appeals and Collection
The Harris Center for Mental Health and IDD —Houston, TX
- Full-time
- Customer service
- Computer literacy
- Research
- Paid time off
- Employee assistance program
Billing Specialist - #4780
Contract Land Staff —Sugar Land, TX
- Microsoft Outlook
- Computer literacy
- Basic math
Medical Billing Collection
ROUND TABLE MEDICAL CONSULTANTS LLC —Houston, TX
- $21 - $24 an hour
- Full-time
- Management
- Computer literacy
- Writing skills
- Health savings account
- Disability insurance
Quick Apply
Patient Account Representative II - Rev Cycle
UTHealth Houston —Houston, TX
- Basic math
- Mid-level
- Microsoft Office
- Mileage reimbursement
- Health insurance
Associate Customer Care Representative
Amica Mutual Insurance Company —Sugar Land, TX
- $22.11 - $26.82 an hour
- Full-time
- Hybrid work
- Background check
- Sales
- High school diploma or GED
- Paid parental leave
- Paid holidays
Quick Apply
12d
Medical Claims Billing Specialist
Privia Health —Houston, TX
- $24.00 - $26.45 an hour
- Full-time
- Hybrid work
- Google Workspace
- Medical office experience
- HIPAA
- Health insurance
- Dental insurance
Quick Apply
13d
Billing Coordinator
Select Water Solutions —Houston, TX
- Full-time
- Research
- Office
- High school diploma or GED
- Paid training
- Paid holidays
Quick Apply
3d
Patient Financial Counselor
CCRM Fertility —Houston, TX
- $22 - $25 an hour
- Weekends as needed
- High school diploma or GED
- Clinic
- US work authorization
- Commuter assistance
- Health savings account
Quick Apply
Healthcare Customer Service Specialist (REMOTE)
GetixHealth —Houston, TX
- $17 an hour
- Full-time
- Remote
- Spanish
- HIPAA
- Research
- AD&D insurance
- Disability insurance
Quick Apply
AR Junior Analyst - P/T Weekends
Fayman & Sorbello Food Group —Houston, TX
- $20 - $31 an hour
- Temporary
- Office
- Finance
- Administrative experience
- AD&D insurance
- Health insurance
Quick Apply
6d
Customer Service Representative
FYZICAL Therapy and Balance Centers —Sugar Land, TX
- $20 an hour
- Full-time
- High school diploma or GED
- Clinic
- Driver's License
- Opportunities for advancement
Quick Apply
Per Diem ASR II - Kelsey Seybold Clinic: Memorial Villages
Optum —Richmond, TX
- $18 - $32 an hour
- Full-time
- Microsoft Word
- Spanish
- Basic math
Quick Apply
Business Office Customer Service Representative - Kelsey Seybold - Pearland Business Office - Hybrid
Optum —Pearland, TX
- $16 - $29 an hour
- Full-time
- Spanish
- Pass drug screening
- Mid-level
Quick Apply
Patient Account Representative Onsite Houston
US Physical Therapy —Houston, TX
- Full-time
- Customer service
- Research
- Office
- Health insurance
- Dental insurance
Quick Apply
Medical Billing Specialists
ROUND TABLE MEDICAL CONSULTANTS LLC —Houston, TX
- $19 - $22 an hour
- Full-time
- Microsoft Word
- Mid-level
- High school diploma or GED
- Health savings account
- Paid holidays
Quick Apply

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Insurance Appeals Rep

PFS Group -
Houston, TX

Apply Now

Job Details

Full-time
12 days ago

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

billing representative jobs in sugar land, tx

Insurance Appeals Rep

Remote Insurance Rep

Insurance Follow-Up Representative III - Kelsey Seybold Clinic - Pearland - Hybrid

Collections Representative - Kelsey Seybold - Pearland

Business Office Coordinator

Revenue Representative – Appeals and Collection

Billing Specialist - #4780

Medical Billing Collection

Patient Account Representative II - Rev Cycle

Associate Customer Care Representative

Medical Claims Billing Specialist

Billing Coordinator

Patient Financial Counselor

Healthcare Customer Service Specialist (REMOTE)

AR Junior Analyst - P/T Weekends

Customer Service Representative

Per Diem ASR II - Kelsey Seybold Clinic: Memorial Villages

Business Office Customer Service Representative - Kelsey Seybold - Pearland Business Office - Hybrid

Patient Account Representative Onsite Houston

Medical Billing Specialists

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