Location: Houston, TX – Memorial City Area (Hybrid - Remote 4 days/week, Onsite Wednesdays)
Schedule: Monday – Friday, 8:00 AM – 5:00 PM
Compensation: $20-22/hr + Full Benefits Package
Position Summary
Are you a sharp, research-driven Medical Collections professional who loves diving into complex claims and overturning tough insurance denials? Medix is partnering with one of the nation's premier health systems in the Memorial City area to hire a Managed Medicare Accounts Receivable Representative for their Physician Billing (PB) team.
In this role, you will take full ownership of outstanding Managed Medicare (Medicare Advantage) claims, using your investigative skills and analytical mindset to resolve discrepancies, prepare appeals, and drive revenue to full resolution. After a thorough 3-to-4-week onsite training period, this position transitions to a highly flexible hybrid schedule, requiring you to be onsite only on Wednesdays.
Why You’ll Love This Position
- Workplace Prestige: Work on behalf of a massive healthcare network nationally recognized by Becker’s Healthcare for clinical excellence.
- Remote Flexibility: Enjoy working from the comfort of your home four days a week after your onsite training period.
- Full Equipment Provided: All necessary IT hardware and software will be issued directly to you by the facility.
Key Responsibilities
- Claim Follow-Up & Resolution: Proactively manage account work queues, contacting insurance carriers regarding outstanding, underpaid, or delayed Managed Medicare claims.
- Advanced Denial Management: Analyze complex denials and rejections, perform deep-dive research to identify root causes, and successfully prepare and submit formal reconsiderations and appeals to overturn payer decisions.
- Account Reconciliation: Verify and document all collection activities, communications, and adjustments accurately within patient account notes.
- High-Volume Execution: Consistently meet or exceed daily performance standards (maintaining a target of working 45 accounts per day with a 90%+ quality and notation accuracy score).
- Compliance: Maintain strict adherence to HIPAA guidelines and internal healthcare system policies.
Required Skills & Qualifications (Must Have)
- Epic EMR Expertise: Minimum of 2 years of direct, hands-on experience navigating Epic AR work queues (proficiency will be vetted during the interview process).
- Physician Billing (PB) Experience: Minimum of 2 years of experience handling professional/physician-side collections (CMS-1500), rather than strictly hospital/facility (UB-04) billing.
- Managed Medicare Mastery: Deep working knowledge of Medicare Advantage/Part C plans (e.g., UnitedHealthcare/AARP, Humana, Aetna, WellCare), including their specific timely filing limits and appeal guidelines.
- Proven Appeal Track Record:固定 Demonstrated ability to independently write appeals and successfully overturn insurance denials.
- Analytical Mindset: A natural knack for research, problem-solving, and digging into complex, tricky claims to find missing documentation or errors.
Preferred Skills
- Ability to thrive and multi-task in a fast-paced, high-volume healthcare environment.
- Strong proficiency in Microsoft Office, with a solid emphasis on Excel, 10-key typing, and basic math skills.
Training & Logistics
- Training Period: First 3–4 weeks will be 100% onsite in the Memorial City area to ensure you are fully supported and set up for success.
- Post-Training Schedule: Hybrid (Remote Monday, Tuesday, Thursday, Friday; Onsite on Wednesdays).
- Dress Code: Business Professional (for onsite days).
*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).
*As a job position within our Revenue Cycle division, a successful completion of a background check may be required as a condition of employment. This requirement is directly related to essential job functions including but not limited to: accessing financial and confidential information, handling financial and other payment data, and working within departments that care for vulnerable populations, such as, minors, elderly and those with physical or mental disabilities. 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.
