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Medical Claims Eligibility Specialist - Billing & Collections

Houston, TX · On-site

$22/hr

Medical Biller, Medical Collections Specialist, Claims Specialist, Insurance Follow-Up Representative, or Healthcare Reimbursement Specialist. Important: Candidates should live within approximately ...

PFS Group

Insurance Appeals Rep

Houston, TX · On-site

The Appeals Representative will be responsible for reviewing basic clinical documentation and ... Demonstrate extensive knowledge of insurance follow-up and denials. * Act as the subject matter ...

PFS Group

Insurance Appeals Rep

Houston, TX · On-site

The Appeals Representative will be responsible for reviewing basic clinical documentation and ... Demonstrate extensive knowledge of insurance follow-up and denials. * Act as the subject matter ...

PFS Group

Follow up Insurance Representative

Houston, TX · On-site

$37K - $45K/yr

The Insurance Representative at PFS Group is responsible for managing client insurance accounts, ensuring customer satisfaction, and maintaining compliance with industry regulations. This role ...

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All JobsInsurance Follow Up Representative JobsInsurance Follow Up Representative Jobs in Houston, TX

Insurance Follow Up Representative information

See Houston, TX salary details

$13

$18

$22

How much do insurance follow up representative jobs pay per hour?

As of Aug 29, 2026, the average hourly pay for insurance follow up representative in Houston, TX is $18.01, according to ZipRecruiter salary data. Most workers in this role earn between $16.06 and $19.28 per hour, depending on experience, location, and employer.

What is an insurance follow up representative?

Insurance Follow Up Representatives are professionals who work in healthcare or insurance organizations to ensure that insurance claims are processed, followed up on, and paid in a timely manner. They review outstanding claims, communicate with insurance companies to resolve issues or denials, and update patient accounts accordingly. Their role is essential for maintaining the financial health of healthcare providers by minimizing delays and maximizing reimbursement from insurance carriers.

What are the key skills and qualifications needed to thrive as an insurance follow up representative?

To thrive as an Insurance Follow Up Representative, you need a solid understanding of medical billing, insurance claims processes, and often a high school diploma or equivalent. Familiarity with healthcare billing software, EHR systems, and payer portals is typically required, and certifications like Certified Revenue Cycle Specialist (CRCS) can be advantageous. Strong attention to detail, persistence, and effective communication skills help you resolve claim denials and collaborate with insurance companies. These skills ensure timely reimbursement, minimize revenue loss, and maintain accurate patient billing records.

What are some common challenges faced by insurance follow up representatives in managing claim denials and how can they be addressed?

Insurance Follow Up Representatives often encounter challenges such as frequent claim denials, delayed payments, and complex payer requirements. To address these, representatives must stay updated on insurance policies, document interactions meticulously, and communicate effectively with both patients and insurance companies. Developing strong problem-solving skills and leveraging claim management software can help streamline the process and reduce errors. Collaboration with billing teams and maintaining up-to-date knowledge of payer rules also play a key role in overcoming these challenges.

What is the difference between Insurance Follow Up Representative vs Claims Processor?

AspectInsurance Follow Up RepresentativeClaims Processor
CredentialsHigh school diploma; some roles may prefer insurance certificationsHigh school diploma; insurance or claims certifications beneficial
Work EnvironmentOffice setting, interacting with insurance companies and clientsOffice setting, reviewing and processing insurance claims
Employer & IndustryInsurance companies, healthcare providersInsurance companies, third-party administrators
Primary FocusFollowing up on unpaid or delayed claims, ensuring paymentReviewing claim details, approving or denying claims

The main difference is that Insurance Follow Up Representatives focus on contacting insurance companies to resolve unpaid claims, while Claims Processors handle the initial review and decision-making on claims. Both roles require knowledge of insurance policies and strong communication skills, but their responsibilities differ in the claims lifecycle.

What are popular job titles related to Insurance Follow Up Representative jobs in Houston, TX?

For Insurance Follow Up Representative jobs in Houston, TX, the most frequently searched job titles are:

What job categories do people searching Insurance Follow Up Representative jobs in Houston, TX look for?

The top searched job categories for Insurance Follow Up Representative jobs in Houston, TX are:

Insurance Follow Up Representative jobs near you
Infographic showing various Insurance Follow Up Representative job openings in Houston, TX as of August 2026, with employment types broken down into 1% As Needed, 74% Full Time, 18% Part Time, 2% Temporary, and 5% Contract. Highlights an 85% Physical, 1% Hybrid, and 14% Remote job distribution, with an average salary of $37,456 per year, or $18 per hour.

Insurance Follow-Up Representative - Medicare Managed Care

Addison Group

Houston, TX • Remote

$21 - $23/hr

Contractor

Medical, Dental, Vision, Life, Retirement

Re-posted 24 days ago

Job description

Job Title: Insurance Follow-Up Representative – Medicare Managed Care

Location: Houston, TX (West Houston)

Industry: Healthcare

Pay: $21–$23 per hour

Job Type: Contract-to-Hire

Benefits: This position is eligible for medical, dental, vision, life insurance and 401k.

About Our Client:

Addison Group is partnering with a healthcare organization seeking an experienced Insurance Follow-Up Representative to support physician billing and collections. This role focuses on resolving Medicare Managed Care claims and is ideal for candidates with strong payer follow-up and denial resolution experience.

Job Description:

The Insurance Follow-Up / Denials Representative will manage assigned accounts within a revenue cycle team, working to resolve denials, rejections, and outstanding claims. This position requires strong knowledge of professional billing workflows, payer guidelines, and the ability to work efficiently within a high-volume environment.

After an initial onsite training period, this role transitions to a hybrid schedule.

Key Responsibilities:

  • Follow up on physician claims and resolve denials, rejections, and unpaid balances.
  • Work within EMR work queues to manage assigned accounts.
  • Communicate with Medicare Managed Care payers to obtain claim status and resolve issues.
  • Submit corrected claims, reconsiderations, and appeals as needed.
  • Analyze EOBs and payer responses to determine appropriate next steps.
  • Identify and resolve billing and registration-related denials.
  • Maintain detailed and accurate documentation of all account activity.
  • Work accounts through full resolution from initial denial to payment.
  • Meet productivity and quality benchmarks.

Requirements:

  • Recent (3-4 years) physician insurance follow-up experience required (CMS-1500 claims).
  • Strong experience with denials, appeals, corrected claims, and rejections.
  • Experience with Medicare Managed Care (MCO) payers required (STAR, STAR+, CHIP, etc.).
  • Familiarity with major payers such as Molina, UHC, Aetna, and similar plans preferred.
  • Experience with Epic or similar EMR systems required.
  • Strong understanding of payer guidelines and claim resolution processes.
  • Ability to work independently and manage high-volume workloads.
  • Strong communication and documentation skills.

Additional Details:

  • Schedule: Monday–Friday, 8-hour shift (start as early as 7:00 AM)
  • Work Model: Hybrid (remote most days with periodic onsite requirements after training)
  • Training: Approximately 1–4 weeks onsite
  • Assignment Type: Contract-to-Hire
  • Environment: Business office revenue cycle team
  • Start Date: ASAP

Perks:

  • Hybrid work flexibility after onboarding
  • Opportunity to gain experience in a large healthcare system environment
  • Strong team support and structured workflows
  • Career growth potential within revenue cycle operations

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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