Senior Claims Specialist - Managed Care & Complex Claims

Pacific Medical Centers; Renton (WA); On-site; USD 60,000 - 80,000; Full time

Benefits offered by this job

401(k) savings plan with employer matching

Health care benefits (medical, dental, vision)

Paid time off

Job summary

Pacific Medical Centers in Renton, Washington is looking for an experienced claims adjudicator to manage and resolve complex claims. The ideal candidate will have a Bachelor's Degree in a related field and at least 4 years of Managed Care operations experience.

This role involves adjusting claims, responding to customer service requests, and serving as a primary resource for the department. Our benefits include a 401(k) plan, health care benefits, and paid time off.

Qualifications

• Bachelor's Degree in a related field or equivalent experience in Health Care Business Administration.
• 4 years of Managed Care operations, including a minimum of 3 years claims processing experience.
• Experience with IDX healthcare software application.

Responsibilities

• Adjudicates claims submitted by outside purchased services.
• Adjusts complex claims for advanced processing needs.
• Acts as primary department resource for major areas of expertise.

Skills

Claims processing

Managed Care operations

Information systems

IDX healthcare software

Knowledge of Medicare/Medicaid

Education

Bachelor's Degree in Health Care Business Administration

Tools

Microsoft Windows

Microsoft Word

Microsoft Excel

Microsoft Mail

Job description

Pacific Medical Centers in Renton, Washington is looking for an experienced claims adjudicator to manage and resolve complex claims. The ideal candidate will have a Bachelor's Degree in a related field and at least 4 years of Managed Care operations experience.

This role involves adjusting claims, responding to customer service requests, and serving as a primary resource for the department. Our benefits include a 401(k) plan, health care benefits, and paid time off.