Medical Claims Billing Specialist

Job overview

The Medical Claims Billing Specialist role is hybrid in Houston, TX, with office attendance Tuesdays and Thursdays and work from home typically Monday, Wednesday, and Friday, subject to change for internal meetings, training, and conferences. The stated base-pay range is $24–$26.45 per hour, with eligibility for an annual bonus targeted at 10% based on performance. The role supports Privia Health’s Revenue Cycle Management team and physician practices. The specialist resolves claims issues and supports accurate, timely reimbursement by investigating denials, making claim-resolution decisions, responding to practice correspondence and cases, and coordinating with internal teams and care-center staff. The work contributes to revenue-cycle performance and physician practice operations.

What you'll do

• Process designated claims accurately and on time
• review and respond to daily correspondence from physician practices
• answer Salesforce cases and provide authorized information
• investigate denial sources and resolve or appeal denials, including contacting payer representatives
• make decisions on claim adjustments, resubmissions, and appeals
• collaborate with internal teams and care-center staff
• support reimbursement aligned with payer contracts
• work with practice consultants or physicians
• contribute to daily and monthly KPIs.

What we're looking for

Skills & competencies

medical claims

billing specialist

revenue cycle management

claims denials

claims appeals

physician practices

hybrid

houston tx

privia health

$24–$26.45/hr

annual bonus target 10%

hipaa

Work arrangement

• Weekend coverage required

Benefits & perks

• Medical, dental, vision, life and pet insurance, 401(k), paid time off, wellness programs, annual bonus eligibility, and expense reimbursement for eligible home-office internet costs.

Why this role

Hybrid schedule with specified in-office days; role includes managing escalated cases and supporting team case resolution.

About the employer

Privia Health is hiring for this role. Industry: Offices of Physicians (except Mental Health Specialists). Sector: 62.