Outpatient Billing & Collections Specialist

Job Description

Job Description

Position: Outpatient Billing and Collections Specialist (Hospital/Insurance Follow-Up)

Location: Remote (Must be based in San Antonio, TX)

Pay Range: $24 – $26 / Hour

Schedule: Monday – Friday, 7:30 AM – 4:00 PM

Benefits: This position is eligible for medical, dental, vision, and 401(k).

Position Overview:

A healthcare organization is seeking experienced Medical Collections Specialists to support insurance follow-up and full-cycle claims resolution. This role focuses on working claims from start to finish , including research, denial resolution, rebilling, and appeals.

Candidates must be located in San Antonio, TX . While the role is currently remote, there is a possibility of transitioning onsite in the future .

Key Responsibilities:

• Perform insurance follow-up on outstanding and aged claims
• Work claims from initial billing through final resolution
• Research and resolve denied or underpaid claims
• Review Explanation of Benefits (EOBs) and determine next steps
• Submit appeals, rebills, and tracers
• Identify and process adjustments, refunds, and bad debt accounts
• Communicate with insurance companies, patients, and third-party payers
• Verify billing information for both electronic and paper claims
• Review remittance advice and ensure accurate reimbursement
• Research payer guidelines and contracts to resolve discrepancies
• Analyze claims and make decisions quickly to drive resolution

Productivity Expectations:

• Target of 18–20 claims per day
• Strong emphasis on quality, accuracy, and timely follow-up

Required Qualifications:

• 2+ years of medical collections experience
• Outpatient claims knowledge
• Government insurance experience (medicaid/medicare)
• Experience working with UB-04 (hospital billing)
• Strong understanding of insurance follow-up and denial resolution
• Knowledge of reimbursement methodologies
• Ability to analyze claims and problem-solve independently
• Basic Excel and computer proficiency

Preferred Qualifications:

• Inpatient (IP) or hospital collections experience
• Experience in LTACH (Long-Term Acute Care Hospital) settings

Systems Used:

• WellSky
• HMS
• Payer portals

Work Environment:

• Remote role (must reside in San Antonio, TX )
• Potential for future onsite requirement
• Central Business Office (CBO) setting
• Collaborative, team-based environment

Additional Details:

• 2-week training period on systems and processes
• No planned time off allowed during the first 90 days (training period)
• Candidates should demonstrate job stability and long-term interest
• Strong communication skills required, including the ability to clearly explain past experience

What Success Looks Like:

• Ability to independently research and resolve complex claims
• Strong critical thinking and attention to detail
• Consistent productivity while maintaining accuracy
• Proactive communication and follow-through

Addison Group is an Equal Opportunity Employer. Addison Group provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, genetic information, marital status, amnesty, or status as a covered veteran in accordance with applicable federal, state and local laws. Addison Group complies with applicable state and local laws governing non-discrimination in employment in every location in which the company has facilities. Reasonable accommodation is available for qualified individuals with disabilities, upon request.

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