We are looking for a dedicated Medical Claims Specialist to join our healthcare team in Federal Way, Washington. This long-term contract position involves working to resolve medical claims efficiently while ensuring compliance with insurance policies and regulations. The role requires strong analytical skills and attention to detail to address complex issues and maintain high productivity standards.<br><br>Responsibilities:<br>• Conduct detailed benefit verification for patient insurance coverage to ensure accurate claims submission.<br>• Investigate and resolve unpaid or denied claims by analyzing root causes and utilizing available resources.<br>• Communicate effectively with insurance payers to address claim issues and facilitate timely payment.<br>• Interpret insurance contracts and regulations, ensuring compliance with state and employer-specific requirements.<br>• Participate in virtual meetings promptly, adhering to meticulous standards and security protocols.<br>• Utilize secure systems to manage sensitive data in a remote environment.<br>• Verify insurance authorizations and approvals accurately to support seamless claim processing.<br>• Collaborate with team members to resolve complex payment barriers and ensure smooth operations.<br>• Manage and resolve a set number of complex accounts daily, meeting productivity expectations.<br>• Respond promptly to supervisor and leadership inquiries during work hours, maintaining a high level of accountability.
