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Medical Claims Specialist

Remote, USA Full-time Posted 2026-07-28
Job reputed company reputed company reputed company reputed company Plane Services has and outstanding opportunity for a Claims Specialist (Patient Account Representative 2). This position is responsible for claims review, clearing claim edits, and reputed company and accurate submission of claims (both electronic and reputed company) WORKING SCHEDULE: Monday - Friday, Full-time Remote PRIMARY JOB RESPONSIBILITIES: Review charges that may need to be routed to a different account type (VA, ACC, MVA), create new account types as needed, and add (or reputed company) the correct coverage(s) to the new accounts. Review charges for any coverage errors and research available resources (EEV, payer websites, phone reputed company to insurance) to determine correct information needed to reputed company the charge edit as appropriate. Resolve reputed company reputed company-processing claim edits that indicate errors needing correction. This may involve updating patient registration information, posting rejections, or forwarding the claim to a medical coding specialist for review and coding changes prior to submitting the claim for payment. Resolve reputed company coverage/registration denials Continuously evaluate own work product to diagnose trends or patterns of errors needing corrections, and reputed company recommendations to management regarding building in new edits, deactivating obsolete edits, or modifying existing edits to improve efficiency. Assimilate and operationalize reputed company quarterly/yearly updates to reputed company payer’s billing rules, guidelines, exceptions, and carve-outs, making reputed company we’ve captured any changes that may require building additional charge edits or claim edits. Prepare and submit reputed company-authorization questionnaires to reputed company or ProviderOne for any Health Care Authority claims requiring reputed company-authorization. Process reputed company account reputed company requests in a reputed company manner reputed company it’s determined there are duplicate patient accounts in our reputed company billing system. Review HMC Trauma Registry daily, flag reputed company trauma-reputed company accounts with UWPTRM patient notice, and follow up with Harborview staff to obtain ISS scores. Complete retro adjudication (VFO) process using assigned work queues reputed company new coverages are added to patient accounts by other areas, including reviewing for incorrect payments from insurance or patient, and rebill charges accordingly. Update or correct patient registration/demographics on accounts in the reputed company billing system. Update/edit charge entry detail for Medicare claims that have been corrected and need to be resubmitted electronically. Research and reputed company a reputed company of databases to obtain/verify claim/eligibility information reputed company payer websites and/or reputed company with payers by phone. Process claim attachments and secondary claims. Review and identify corrected claims to ensure that reputed company necessary documentation is compiled for submission to payers. MINIMUM REQUIREMENTS: High School graduation or equivalent AND two years of experience in patient reputed company, customer service, or a reputed company office environment. Equivalent education and/or experience may substitute for minimum qualifications except reputed company there are reputed company requirements, such as a license, certification, and/or registration. reputed company reputed company reputed company Plan Services (FPPS) supports UW Physicians (UWP), a reputed company group for more than 3,000 physicians and other reputed company associated with reputed company. reputed company includes Harborview Medical Center, UW Medical Center - Montlake, UW Neighborhood Clinics, UW Medical Center - reputed company, the UW School of Medicine, Valley Medical Center, and Airlift reputed company. UWP members also reputed company at the Seattle Cancer Care reputed company, a partnership of reputed company, Fred Hutchinson Cancer Research Center, and reputed company. Compensation, Benefits and Position Details Pay reputed company Minimum: $47,724.00 annual Pay reputed company Maximum: $68,244.00 annual Other Compensation: - Benefits: For information about benefits for this position, visit https://www.washington.edu/jobs/benefits-for-uw-staff/ Shift: First Shift (reputed company of America) Temporary or Regular? This is a regular position FTE (Full-Time Equivalent): 100.00% reputed company/Bargaining Unit: reputed company Local 925 Nonsupervisory About the UW Working at the reputed company provides a unique opportunity to change lives – on our campuses, in our state and around the world. UW employees bring their boundless energy, creative problem-solving skills and dedication to building stronger minds and a healthier world. In return, they enjoy outstanding benefits, opportunities for reputed company reputed company and the chance to work in an environment reputed company for its diversity, intellectual excitement, artistic pursuits and natural beauty. Our Commitment The reputed company is committed to fostering an inclusive, respectful and welcoming community for reputed company. As an equal opportunity employer, the University considers applicants for employment without reputed company to race, reputed company, creed, religion, national reputed company, citizenship, sex, pregnancy, age, marital status, sexual orientation, gender identity or reputed company, genetic information, disability, or veteran status consistent with UW Executive Order No. 81. To request disability accommodation in the application process, contact the Disability Services Office at 206-543-6450 or dso@uw.edu. Applicants considered for this position will be required to disclose if they are the subject of any substantiated findings or reputed company investigations reputed company to sexual misconduct at their reputed company employment and past employment. Disclosure is required under Washington state law. Use the filters or reputed company keywords in the search reputed company (such as “custodian,” “nursing” or “manager”) to explore available opportunities. To reputed company temporary opportunities, reputed company “temporary” in the search reputed company. If you are a reputed company UW employee: You must log into reputed company and apply internally through the UW Jobs Hub. Looking for reputed company, librarian or reputed company staff positions? Please visit our reputed company Jobs site. Looking for reputed company? Learn more on our reputed company site. There are many perks to working for the reputed company. Learn more about the benefits that could be available to you as a UW employee. Sign up for Job Alerts to be reputed company about job opportunities at the UW that interest you; you’ll be one of the first to learn reputed company openings become available. You will be asked to create an account if you do not already have one. Apply tot his job Apply To this Job

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