Remote Healthcare Claims Adjudicator

First Choice Health Ltd; Seattle (WA); Remote; USD 25,000 - 32,000; Full time

Benefits offered by this job

Health insurance

401(k) with employer match

Paid time off (PTO)

Employee assistance program (EAP)

Job summary

First Choice Health, headquartered in Seattle, WA, is seeking a TPA Claims professional for a full-time remote role. You will oversee timely adjudication for all clients, handling data entry and multiple claim types (Institutional, Professional, Dental) while maintaining strict privacy and accuracy standards.

The position requires a High School Diploma, 1-2 years in healthcare, and basic computer skills including Word, Windows, and Google Workspace.

Qualifications

• High School Diploma or equivalent.
• 1-2 years healthcare industry experience.
• Basic computer skills including Word processing and Google Workspace.

Responsibilities

• Process EDI Errors accurately.
• Process Institutional, Professional and Dental claims.
• Review, research, and resolve claims per contracts and policies.
• Maintain department productivity and quality standards for adjudicating claims.
• Comply with privacy, integrity, confidentiality and PHI handling.
• Provide feedback to unit Manager on plan benefits, BQT and system issues.
• Handle all levels of claims procedures including actions, correspondence, audits and adjustments.
• Other projects as assigned.

Skills

Data entry

Word processing

Google Workspace

Windows OS

Education

High School Diploma or equivalent

Tools

EDI systems

Job description

First Choice Health, headquartered in Seattle, WA, is seeking a TPA Claims professional for a full-time remote role. You will oversee timely adjudication for all clients, handling data entry and multiple claim types (Institutional, Professional, Dental) while maintaining strict privacy and accuracy standards.

The position requires a High School Diploma, 1-2 years in healthcare, and basic computer skills including Word, Windows, and Google Workspace.