Medical Collections Specialist

Job Description

Job Description

Medical Collections Specialist (Inpatient Hospital Claims)

Location: Houston, TX 77056
Schedule: Monday - Friday | Onsite
Hours: Standard business hours with a flexible schedule between 9:00 AM - 3:00 PM . Potential for future hybrid work based on performance and business needs.

About the Role

We are seeking an experienced, results-driven Medical Collections Specialist to join our Central Business Office. This position is responsible for the aggressive follow-up, appeal, and resolution of unpaid or denied inpatient hospital claims with government and commercial insurance payers.

The ideal candidate is persistent, analytical, and detail-oriented with extensive experience working inpatient UB-04 claims, researching payer denials, navigating payer portals, and successfully overturning high-dollar DRG and medical necessity denials. If you thrive on solving complex reimbursement issues and maximizing hospital revenue, we'd love to hear from you.

Key Responsibilities

• Follow up on outstanding inpatient hospital claims with Medicare, Medicaid, managed care, and commercial insurance payers.
• Review unpaid claims, denials, and underpayments to determine the root cause of delayed reimbursement.
• Monitor claims through clearinghouses and payer portals, tracking claim acceptance, processing status, and final adjudication.
• Research and resolve claim rejections, denials, and unpaid balances in a timely manner.
• Prepare and submit corrected claims, appeals, reconsiderations, and rebills as necessary.
• Analyze remittance advice (ERAs/EOBs) and payer correspondence to identify reimbursement discrepancies.
• Utilize medical billing knowledge, UB-04 claim experience, and payer-specific guidelines to maximize reimbursement.
• Verify all supporting documentation required for successful appeals and claim resolution.
• Collaborate with internal departments and facility staff to obtain medical records and additional documentation needed for appeals.
• Maintain accurate documentation of collection activities, payer communications, and account updates within billing systems.
• Identify denial trends and recommend process improvements that positively impact revenue cycle performance.
• Ensure compliance with all federal, state, HIPAA, and payer-specific regulations.
• Assist with additional revenue cycle and business office responsibilities as assigned.

Qualifications

Required:

• Minimum of 2 years of inpatient hospital medical collections experience .
• Strong knowledge of UB-04 billing , inpatient reimbursement methodologies, and hospital revenue cycle operations.
• Experience working Medicare, Medicaid, managed care, and commercial insurance accounts.

What We Offer

• Competitive compensation based on experience
• Monday-Friday schedule with work-life balance
• Opportunity for future hybrid work
• Supportive and collaborative team environment
• Career growth within an expanding healthcare organization
• Comprehensive benefits package (if applicable)

Apply Today

If you're an experienced inpatient medical collections professional who is passionate about resolving complex claims, recovering revenue, and making a measurable impact on the financial health of a healthcare organization, we encourage you to apply.

For California Applicants:

We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO) , and the California Fair Chance Act (CFCA).

This position is subject to a background check based on its job duties, which may include patient care, working with vulnerable populations, access to financial and confidential information, driving, working with heavy machinery, or working in a warehouse or laboratory environment. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.

Company Description

Here at Medix, we are dedicated to providing workforce solutions to clients throughout multiple industries. We have been named among the Best and Brightest Companies to Work For in the Nation for two consecutive years. Medix has also been ranked as one of the fastest growing companies by Inc. Magazine.

Our commitment to our core purpose of positively impacting 20,000 lives affects not only the way we interact with our clients and talent, but also with our co-workers! The goal is lofty, but it is made attainable through the hard work and dedication of our teams and their willingness to lock arms together. Are you ready to lock arms with us?

Company Description

Here at Medix, we are dedicated to providing workforce solutions to clients throughout multiple industries. We have been named among the Best and Brightest Companies to Work For in the Nation for two consecutive years. Medix has also been ranked as one of the fastest growing companies by Inc. Magazine.\r\n\r\nOur commitment to our core purpose of positively impacting 20,000 lives affects not only the way we interact with our clients and talent, but also with our co-workers! The goal is lofty, but it is made attainable through the hard work and dedication of our teams and their willingness to lock arms together. Are you ready to lock arms with us?