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Hospital Insurance Jobs (NOW HIRING)

PFS Group

Insurance Appeals Rep

Houston, TX · On-site

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 ...

PFS Group

Insurance Appeals Rep

Houston, TX

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 ...

HSS

Director of Insurance

New York, NY · On-site

$112K - $170K/yr

HSS is consistently among the top-ranked hospitals for orthopedics and rheumatology by U.S. News ... The team monitors insurance industry trends and evaluates coverage limits and any gaps. The ...

USPI, INC.

Insurance Verifier

Arlington, TX · On-site

Join a 38-bed hospital that has proudly been serving Arlington residents and patients from across the region since 2010. We're not just a hospital; we're the only specialized facility of our kind in ...

New

United Surgical Partners

Insurance Verifier

Dallas, TX · On-site

Baylor Scott & White Orthopedic and Spine Hospital - Arlington is hiring a Full Time Insurance Verifier! Welcome to Baylor Scott & White Orthopedic and Spine Hospital - Arlington , TX, where we focus ...

Mountain Health Network

Security Officer

Huntington, WV

$13.50 - $16.25/hr

Meet Hospital Insurance Carrier requirements Physical Demands: * Must be able to reach, stoop, bend, and crouch. * Must be able to adapt to rapidly changing environmental conditions. * Must possess ...

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Showing results 21-40

All JobsHospital Insurance Jobs

Hospital Insurance information

See salary details

$23.5K

$59.1K

$97.5K

How much do hospital insurance jobs pay per year?

As of Aug 12, 2026, the average yearly pay for hospital insurance in the United States is $59,095.00, according to ZipRecruiter salary data. Most workers in this role earn between $40,500.00 and $77,500.00 per year, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a hospital insurance specialist, and why are they important?

To thrive as a Hospital Insurance Specialist, you need in-depth knowledge of healthcare billing and coding, insurance claims processing, and familiarity with regulations such as HIPAA, often supported by a relevant associate degree or certification (e.g., CPC, CPB). Proficiency with medical billing software, electronic health records (EHR), and payer portal systems is essential. Strong attention to detail, problem-solving abilities, and effective communication skills help specialists resolve claim issues and interact with patients and insurers. These skills ensure accurate claim submissions, timely reimbursements, and compliance with healthcare regulations, which are critical for hospital revenue and patient satisfaction.

What is the difference between Hospital Insurance vs Medical Billing Specialist?

AspectHospital InsuranceMedical Billing Specialist
CredentialsTypically requires health insurance knowledge, certifications like AHIP or HIPAA complianceRequires coding certifications (CPC, CCS), billing software proficiency
Work EnvironmentHospitals, clinics, insurance companiesMedical offices, billing companies, healthcare providers
Industry UsageInsurance providers, healthcare facilitiesHealthcare providers, billing services

Hospital Insurance focuses on managing and administering health insurance plans, including policy coverage and claims processing. Medical Billing Specialists handle the coding, billing, and reimbursement processes for healthcare services. While both roles are essential in healthcare finance, Hospital Insurance professionals primarily work with insurance policies and claims, whereas Medical Billing Specialists focus on translating medical services into billable codes and ensuring accurate payments.

What is hospital insurance and what does it cover?

Hospital insurance, often referred to as health insurance or inpatient coverage, is a type of insurance policy that helps pay for expenses related to hospital stays. It typically covers room and board, nursing care, diagnostic tests, surgery, and other services provided while you are admitted as an inpatient. Hospital insurance may also cover some outpatient services, but its main focus is on hospitalization costs. The extent of coverage depends on the specific plan, so it's important to review policy details to understand what is and isn't included.

What are some common challenges faced by hospital insurance professionals when coordinating claims with healthcare providers?

Hospital insurance professionals often encounter challenges such as navigating complex medical billing codes, ensuring timely and accurate documentation from healthcare providers, and resolving discrepancies between what was billed and what is covered. Effective coordination requires strong communication skills to clarify information with medical staff and to advocate for patients’ coverage. Additionally, staying up-to-date with frequently changing regulations and policies is crucial to minimize claim denials and ensure compliance.
More about Hospital Insurance jobs
What cities are hiring for Hospital Insurance jobs? Cities with the most Hospital Insurance job openings:
What states have the most Hospital Insurance jobs? States with the most job openings for Hospital Insurance jobs include:
What job categories do people searching Hospital Insurance jobs look for? The top searched job categories for Hospital Insurance jobs are:
Hospital Insurance jobs near you
Infographic showing various Hospital Insurance job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 73% Full Time, 21% Part Time, and 5% Contract. Highlights an 96% Physical, 1% Hybrid, and 3% Remote job distribution, with an average salary of $59,095 per year, or $28.4 per hour.

Insurance Appeals Rep

PFS Group

Houston, TX • On-site

Full-time

Medical, Dental, Vision, Life, Retirement

Posted 26 days ago

Job description

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
  1. Demonstrate extensive knowledge of insurance follow-up and denials.
  2. Act as the subject matter expert for appeals on their team.
  3. Triage and determine denial reasons from remittance advice, explanation of benefits, payer portals, or other avenues of information.
  4. Research pertinent payer medical policy bulletins and billing guidelines, creating a repository of reference materials for themselves and other team members.
  5. Prioritize work effort by viability and amount of payment to maximize cash.
  6. Track payer issues and escalations to provide relevant trending information to leadership.
  7. Follow appeals to resolution to assess effectiveness.
  8. Create job aids and share information on appeals language as needed.
  9. Practice compliant billing and follow-up strategies for all government and managed care payers.
  10. Meet minimum of 10 appeals per day, as well as any follow-up needed on existing appeals.
  11. Aggressively seek to resolve unpaid balances.
  12. Document all efforts accurately and thoroughly.
  13. Follow all workflow protocols.
  14. Work other insurance inventory as assigned or as volume demands.

KNOWLEDGE, SKILLS, AND ABILITIES
  1. Outstanding research and follow-up skills.
  2. Deep knowledge of denial types and causes.
  3. Ability to research commercial, managed care, and government payer guidelines and reference language in all appeals.
  4. Ability to read and interpret remittance advice/explanation of benefits.
  5. Strong written and verbal communication skills, especially when drafting appeals or creating workflow templates for teammates.
  6. Self-motivation and ability to work autonomously.
  7. Basic analytics, to include Microsoft Excel.

EDUCATION AND EXPERIENCE
  1. At least 6 months as an Insurance Representative at PFS Group, or 12 months of equivalent experience from a comparable organization.
  2. At least 2 years of hospital insurance follow-up or denials experience.
  3. Epic experience, with strong preference toward HB, required.

Preferences
  1. 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

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