Claim Submission Specialist

Radiology Partners, Inc.; United States; Remote; USD 25,000 - 28,000; Full time

Benefits offered by this job

Competitive benefits

Remote schedules

Generous PTO

Great Place to Work

Job summary

Radiology Partners is seeking a detail-oriented Medical Billing Specialist to join our Revenue Cycle team in the United States. You will review, submit, and correct medical claims to payer systems, ensuring accurate patient and provider data and adherence to billing rules.

You will collaborate with internal teams and offshore vendors to resolve claim issues, reduce denials, and support clean claim rates. Strong Excel skills and knowledge of Medicare/Medicaid billing are essential.

Qualifications

• 3+ years of experience in medical billing or related healthcare operations.
• Working knowledge of insurance billing workflows and payer requirements.
• Experience with Medicare, Medicaid, and commercial billing.

Responsibilities

• Review and submit medical claims to payers per requirements.
• Validate patient demographics, insurance and provider data.
• Resolve edits and rejections by researching requirements.
• Collaborate with Revenue Cycle teams and offshore vendors to resolve issues.
• Identify recurring claim issues and support process improvements.

Skills

Medical billing

Claims processing

Revenue Cycle Management

Data accuracy

Analytical skills

Microsoft Office (Excel, Word, Outlook

Education

High school diploma or GED

Tools

PHIcure

Imagine

Availity

Clearinghouse systems

Job description

WHO WE ARE AND WHAT WE DO:

Radiology Partners, through its affiliated practices, is a leading radiology practice in the U.S., serving hospitals and other healthcare facilities across the nation. As a physician-led and physician-owned practice, our mission is to transform radiology by innovating across clinical value, technology, service, and economics, while elevating the role of radiology and radiologists in healthcare. Using a proven healthcare services model, Radiology Partners provides consistent, high-quality care to patients, while delivering enhanced value to the hospitals, clinics, imaging centers and referring physicians we serve.

POSITION SUMMARY:

• Review, correct, and submit medical claims to insurance payers in accordance with payer requirements, billing regulations, and organizational standards.
• Validate patient demographics, insurance coverage, provider information, and claim data to support accurate and timely claim submission.
• Resolve claim edits, clearinghouse rejections, and payer rejections by researching requirements and correcting submission errors.
• Collaborate with internal Revenue Cycle teams and offshore vendors to resolve claim issues, maintain quality standards, and reduce rework.
• Identify recurring claim issues, support root-cause analysis, and contribute to process improvements that improve clean claim rates and reimbursement outcomes.

DESIRED PROFESSIONAL SKILLS AND EXPERIENCE:

• High school diploma or GED required, with 3+ years of experience in medical billing, claims processing, claims submission, Revenue Cycle Management, or related healthcare operations.
• Working knowledge of medical claims, insurance billing workflows, payer requirements, claim edits, and clearinghouse (PHIcure) processes.
• Experience with Medicare, Medicaid, Medicare Advantage, and commercial insurance billing requirements.
• Proficiency in Microsoft Office, particularly Excel, Word, and Outlook, and experience with healthcare billing or practice management systems.
• Strong analytical, research, problem-solving, organizational, and communication skills, with attention to detail and the ability to manage high-volume workloads; experience with Imagine, Availity, or similar systems preferred.

WHY RADIOLOGY PARTNERS:

• Competitive Benefits package - Eligibility starts the month after hire, with tiered options to choose from.
• Flexible Remote Schedules
• Generous PTO Plans and Paid Holidays
• Proudly Certified as a Great Place to Work for Five Consecutive Years

COMPENSATION

The pay range for this position is $18.00-$20.00 / hr. Final determinations may vary based on several factors including but not limited to education, work experience, certifications, geographic location, etc. This role is also eligible for an annual discretionary bonus. In addition to this range, Radiology Partners offers competitive total rewards packages, which include health & wellness coverage options, 401(k) benefits, and a broad range of other benefits such as family planning and telehealth (all benefits are subject to eligibility requirements).

Radiology Partners is an equal opportunity employer. RP is committed to being an inclusive, safe and welcoming environment where everyone has equal access and equitable resources to reach their full potential. We are united by our Mission to Transform Radiology and in turn have an important impact on the patients we serve and the healthcare system overall. Diversity is a key source of strength, and we strive to foster a culture that is inclusive for all.

CCPA Notice: When you submit a job application or resume, you are providing the Practice with the following categories of personal information that the Practice will use for the purpose of evaluating your candidacy for employment: (1) Personal Identifiers; and (2) Education and Employment History.

Radiology Partners participates in E-Verify.

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