Remote Medical Claims Specialist: Payer Billing

Agence PROvidence; Seattle (WA); Remote; USD 48,000 - 64,000; Full time

Job summary

Providence Swedish is seeking a remote Insurance Claims Billing Specialist to prepare, edit and submit accurate claims to Medicare, Medicaid and related payers. The role supports primary and secondary claims, reviews edits in EPIC and a claims scrubber, and ensures timely filing.

You will reconcile claim runs, generate electronic files, resolve errors with the clearinghouse or vendor, and identify recurring billing issues for improvement.

Qualifications

• Medical terminology and medical coding training or equivalent on-the-job training.
• Minimum 1 year of hospital insurance regulatory billing experience including Medicare, Medicaid and/or L&I.

Responsibilities

• Prepare, edit and submit accurate claims to regulatory payers (Medicare, Medicaid, L&I, VA, etc.).
• Review and resolve billing edits in EPIC and in claims scrubber system; verify accuracy of claims submitted to payers.
• Reconcile claim runs, create electronic claim files and resolve errors with clearinghouse or scrubber vendor.
• Identify recurring billing errors and trends; report to supervisor.
• Research coding errors, document billing issues, and assist with problem solving and solutions.
• Process credit balances due to regulatory payers.

Skills

Medical terminology

Medical coding

EPIC experience

Regulatory billing

L&I experience

Education

Bachelor's degree in Finance, Business Management or health care administration

Tools

Provider One

MECA

FSS0

CWF

Job description

Providence Swedish is seeking a remote Insurance Claims Billing Specialist to prepare, edit and submit accurate claims to Medicare, Medicaid and related payers. The role supports primary and secondary claims, reviews edits in EPIC and a claims scrubber, and ensures timely filing.

You will reconcile claim runs, generate electronic files, resolve errors with the clearinghouse or vendor, and identify recurring billing issues for improvement.