Remote Senior Patient Billing & Claims Specialist

Providence Health Plan Group; Seattle, Northern (WA, KY); Hybrid; USD 44,000 - 65,000; Full time

Job summary

Providence Swedish is seeking a Remote Claims Specialist to prepare, edit and submit insurance claims to regulatory payers (Medicare, Medicaid, L&I, VA, and others). You will ensure accuracy of claims and manage electronic and manual submissions from a remote location.

Responsibilities include reviewing edits in EPIC and scrubber systems, reconciling claim runs, and resolving errors with third-party clearinghouses. You will analyze trends to prevent recurring issues and support problem solving.

Qualifications

• Medical terminology and medical coding training in an accredited school or equivalent on-the-job training in a billing role.
• 1 year of experience in hospital insurance regulatory billing, including Medicare, Medicaid and/or Labor & Industries (L&I).

Responsibilities

• Prepare, edit and submit accurate and timely insurance claims to regulatory payers (Medicare, Medicaid, L&I, VA, Crime Victims & Healthy Options).
• Review and resolve billing edits in EPIC and in the claims scrubber system; verify accuracy of submitted claims.
• Reconcile claim runs, create electronic claim files, and resolve errors with third-party clearinghouses or scrubber vendors.
• Identify recurring billing errors and trends; report findings to supervisor and assist with problem solving.

Skills

Medical terminology

Medical coding

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 Claims Specialist to prepare, edit and submit insurance claims to regulatory payers (Medicare, Medicaid, L&I, VA, and others). You will ensure accuracy of claims and manage electronic and manual submissions from a remote location.

Responsibilities include reviewing edits in EPIC and scrubber systems, reconciling claim runs, and resolving errors with third-party clearinghouses. You will analyze trends to prevent recurring issues and support problem solving.