Medical Insurance Collector (Greater Houston Residents)

About the position

The Medical Insurance Collector at Nutex Health is responsible for managing out-of-network collection activities related to complex denials and outstanding balances with various payors. This role requires in-depth knowledge of collection processes and medical insurance providers, as well as strong problem-solving and organizational skills. The position is full-time and offers the potential for remote work after an initial training period.

Responsibilities
• Perform out-of-network collection activities on complex denials.
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• Prepare appeals and necessary actions on outstanding balances with major payors.
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• Respond to correspondence from insurance carriers.
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• Research, appeal, and resolve unpaid insurance claims.
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• Work assigned claim volume timely and efficiently within corporate timeframes.
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• Follow up on payment errors and review postings before approving patient statements.
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• Initiate collection follow-up on unpaid or denied claims with appropriate insurance carriers.
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• Ensure payment meets the qualified payment amount required by the No Surprises Act.
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• Follow all processes and procedures set by department leadership.
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• Meet performance goals for efficiency, accuracy, quality, member satisfaction, and attendance.
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• Stay informed of changes in procedures, billing guidelines, and laws for assigned insurance carriers.

Requirements
• Minimum of three (3) years' experience in Out of Network Facility and Physician Hospital Claims.
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• Experience administering appeals in a high-volume claim environment.
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• Strong knowledge of insurance plan providers such as BCBS, UHC, Aetna/Cigna, and self-funded/commercial providers.
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• Experience reading, analyzing, and interpreting medical Explanation of Benefits.
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• Familiarity with computer and Windows PC applications such as Excel and Word.

Nice-to-haves
• Working knowledge of NSA (No Surprises Act).
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• Ability to type 45-60 WPM.

Benefits
• $0 Premium Benefits- Medical, Dental, Vision
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• 401K
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• STD / LTD
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• $50K Basic Life Insurance
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• Supplemental Policies
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• Employee Stock Purchase Program
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• Employee Assistance Program

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