Remote Healthcare Claims Specialist

vTech Solution; Washington (District of Columbia); Remote; USD 52,000 - 64,000; Full time

Job summary

vTech Solution is seeking a Claims Specialist to ensure accuracy of patient accounts and claim information for timely billing and reimbursement.

The role involves monitoring electronic transmissions, researching denials, and coordinating with patients, providers, and insurers while staying compliant with government regulations.

The position requires on-site orientation at our Seattle clinic with subsequent remote work options, and candidates must reside in Washington state.

Qualifications

• Minimum 2 years of experience in a healthcare business setting or related education.
• At least 1 year of experience using the EPIC platform.
• Minimum 1 year of successful customer service experience with patients and insurers.
• Strong knowledge of managed care principles, insurance industry practices, and medical terminology.
• Working knowledge of CPT, ICD-10 coding, and Correct Coding Initiatives.
• Excellent analytical, organizational, verbal, written, and interpersonal communication skills.
• Ability to operate data entry equipment and related computer systems with typing skills of 40 wpm.

Responsibilities

• Ensure all billing documentation, including CPT-4, HCPCS, and ICD-10 coding, prior authorizations, and patient demographics, are complete and accurate.
• Monitor daily electronic claims transmission and research system and clearinghouse claim rejections to maximize successful claim processing.
• Perform follow-up with patients and insurance payers to ensure timely and accurate resolution of accounts.
• Research and resolve insurance denials and coding inconsistencies per departmental guidelines.
• Maintain working knowledge of registration, billing, electronic data interchange, and payer-specific policies.
• Collaborate with team members and communicate professionally with patients, providers, and insurance representatives.
• Operate billing and registration equipment safely and report malfunctions.
• Analyze and resolve errors or problems using available resources and department guidelines.
• Maintain compliance with federal, state, and organizational laws, regulations, and guidelines.
• Participate in educational programs and in-services to stay current with industry changes.

Skills

Healthcare billing

Customer communication

Attention to detail

Regulatory compliance

Tools

EPIC platform

Job description

vTech Solution is seeking a Claims Specialist to ensure accuracy of patient accounts and claim information for timely billing and reimbursement.

The role involves monitoring electronic transmissions, researching denials, and coordinating with patients, providers, and insurers while staying compliant with government regulations.

The position requires on-site orientation at our Seattle clinic with subsequent remote work options, and candidates must reside in Washington state.