Insurance Follow-Up Representative (Medicaid)

Location: Houston, TX (West Houston)

Industry: Healthcare / Revenue Cycle

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 large healthcare organization seeking an Insurance Follow-Up Representative to join their physician revenue cycle team. This role focuses on resolving Medicaid Managed Care claims and denials while ensuring timely reimbursement and claim resolution.

This is a great opportunity for revenue cycle professionals looking to work within a large healthcare system with long-term career growth potential.

Job Description

The Insurance Follow-Up Representative will work within the revenue cycle team to resolve denied or unresolved physician claims. The role involves working directly with Medicaid Managed Care payers to research claim issues, submit appeals, and ensure claims are processed accurately.

Key Responsibilities

• Follow up on physician insurance claims and resolve denials or payment delays.
• Work within Epic work queues to manage assigned accounts.
• Investigate claim issues such as billing denials, coverage issues, and registration errors.
• Submit corrected claims, reconsiderations, and appeals when appropriate.
• Communicate with insurance payers to determine claim status and resolution.
• Analyze EOBs and payer responses to identify next steps for reimbursement.
• Ensure accounts are worked through to full resolution.
• Maintain accurate documentation of payer communication and claim activity.
• Meet productivity expectations while maintaining quality standards.

Qualifications

• Recent physician insurance follow-up experience required (CMS-1500 claims).
• Strong experience handling denials, appeals, corrected claims, and rejections.
• Experience working with Medicaid Managed Care (MCO) payers required.
• Experience working within Epic or similar EMR systems strongly preferred.
• Strong understanding of payer guidelines and claim resolution processes.
• Ability to work independently and manage assigned accounts efficiently.

Additional Details

• Schedule: MondayFriday, 8-hour shift (start as early as 7:00 AM)
• Work Model: Hybrid remote most days with periodic onsite work after training
• Training: Approximately 14 weeks onsite depending on training schedule
• Environment: Business Office / Revenue Cycle Team
• Start Date: ASAP - Open to a notice

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.