Claims Specialist

Providence Health & Services; Seattle (WA); Hybrid; USD 30,000 - 46,000; Full time

Job summary

Providence Health & Services seeks a Claims Specialist to ensure patient accounts and claim information are accurate for timely billing and optimal reimbursement. You will monitor daily electronic claims transmission, research and resolve denials, and coordinate with registration, edits, and follow-up to keep accounts moving.

You will collaborate with insurance companies, hospital staff, physicians, and patients to resolve issues, ensure compliance with government regulations, and support our

Qualifications

• 2 years of experience in a healthcare business setting or related education.
• 1 year experience using the EPIC platform.
• 1 year of successful customer service experience with patients and insurers.

Responsibilities

• Ensure patient accounts and claims data are accurate for timely billing.
• Monitor electronic claims transmission and resolve denials to maximize processing without errors.
• Coordinate billing activities with registration, edits, and follow-up teams.
• Collaborate with insurance companies, hospital staff, physicians, and patients to resolve issues.

Skills

Customer service

Healthcare experience

Education

Related field education

Tools

EPIC

Job description

Description

The Claims Specialist ensures patient account and claim information contains comprehensive and accurate data to provide for timely billing and optimal reimbursement for services. Monitors daily electronic claims transmission to research and resolve system and electronic clearinghouse claim rejection to maximize the number and percentage of patient bills processed without denials or errors. Responsible for ensuring all claims are accurate and compliant with government rules and regulations.Coordinates billing within the functions of registration, edits, and follow up. Works closely and communicates with insurance companies, government payers, hospital staff, physicians, patients and others to ensure timely billing and resolution of patient accounts.

Required Qualifications:

• 2 years experience in healthcare business setting, education in a related field is accepted in lieu of this work experience
• 1 year experience using EPIC platform
• 1 year successful customer service experience with patients and insurers

Why Join Providence?

Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security. We take care of you, so you can focus on delivering our mission to advocate, educate and provide extraordinary care.

About Providence

At Providence, our strength lies in Our Promise of "Know me, care for me, ease my way." Working at our family of organizations means that regardless of your role, we'll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable.

Posted are the minimum and the maximum wage rates on the wage range for this position. The successful candidate's placement on the wage range for this position will be determined based upon relevant job experience and other applicable factors. These amounts are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.

Providence offers a comprehensive benefits package including a retirement 401(k) Savings Plan with employer matching, health care benefits (medical, dental, vision), life insurance, disability insurance, time off benefits (paid parental leave, vacations, holidays, health issues), voluntary benefits, well-being resources and much more. Learn more at providence.jobs/benefits.

Applicants in the Unincorporated County of Los Angeles: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Unincorporated Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act.

About the Team

Pacific Medical Centers (PacMed) is a private, not-for-profit, primary and integrated multi-specialty health care network with outpatient clinics and primary and specialty care providers in King, Snohomish and Pierce counties. We combine decades of patient-centered care with cutting-edge technology, first-class facilities and board-certified providers.

Our strong team environment and respect for our people-at all levels and from all backgrounds-allow us to provide authentic care that achieves the highest-quality patient outcomes, backed by the strong network of resources and support through our affiliation with the Providence family, including local partners like Swedish Health Services.

Providence is proud to be an Equal Opportunity Employer. We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law. We believe diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement.

For any concerns with this posting relating to the posting requirements in RCW 49.58.110(1), please click here where you can access an email link to submit your concern.

Requsition ID: 453362

Company: Pacific Medical Jobs

Job Category: Claims

Job Function: Revenue Cycle

Job Schedule: Full time

Job Shift: Day

Career Track: Admin Support

Department: 3060 OTHER FISCAL SERVICES WA

Address: WA Seattle 1200 12th Ave S

Work Location: PACMED Admin Bh-Seattle

Workplace Type: Hybrid

Pay Range: $21.55 - $33.53

The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.