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We are looking for a dedicated Medical Claims Specialist to join our healthcare team in Federal Way, Washington. This long-term contract position involves working to resolve medical claims efficiently while ensuring compliance with insurance policies and regulations. The role requires strong analytical skills and attention to detail to address complex issues and maintain high productivity standards.
Job Responsibility:
Conduct detailed benefit verification for patient insurance coverage to ensure accurate claims submission
Investigate and resolve unpaid or denied claims by analyzing root causes and utilizing available resources
Communicate effectively with insurance payers to address claim issues and facilitate timely payment
Interpret insurance contracts and regulations, ensuring compliance with state and employer-specific requirements
Participate in virtual meetings promptly, adhering to meticulous standards and security protocols
Utilize secure systems to manage sensitive data in a remote environment
Verify insurance authorizations and approvals accurately to support seamless claim processing
Collaborate with team members to resolve complex payment barriers and ensure smooth operations
Manage and resolve a set number of complex accounts daily, meeting productivity expectations
Respond promptly to supervisor and leadership inquiries during work hours, maintaining a high level of accountability
Requirements:
Proven experience in medical collections, claims resolution, or revenue cycle management
Strong ability to interpret insurance contracts, documents, and regulatory guidelines
Knowledge of benefit verification and authorization processes within healthcare
Analytical skills to identify and address root causes of claim denials effectively
Reliable high-speed internet and familiarity with secure remote work systems
Proficiency in video conferencing and adherence to remote communication protocols
High level of responsiveness, urgency, and accountability in managing tasks
Ability to work exclusively for the organization without concurrent external roles
What we offer:
medical, vision, dental, and life and disability insurance