Claims Specialist (Remote) A health services organization is seeking a Claims Specialist for a long-term contract opportunity. This role focuses on hospital claims processing, charge review, edits, and account resolution within a collaborative claims operations environment.

About the

Opportunity:

• Shift:

  Day shift

• Schedule:

  Monday to Friday

• Hours:

  8am to 5pm or 9am to 6pm

•

Setting:

RemoteResponsibilities:

• Review inpatient and outpatient hospital accounts for accurate claim submission and compliance with payer guidelines
• Research and resolve billing errors, claim edits, and account issues related to denials and rejections
• Review charges and support billing integrity processes, including adjustments and edit resolution
• Validate coverage and process primary, secondary, and billing claims accurately from end to end
• Support account consolidation, medical records handling, and document upload and download activities as needed

Qualifications:

• 1+ year of relevant work experience
• High School Diploma / GED
• Recent NextGen system experience
• Revenue cycle management experience
• Experience working with hospital claims, billing, or claims processing workflows
• Ability to work Monday through Friday during Arizona business hours year-round

Desired Skills:

• Associate's and/or Bachelor's Degree
• Experience with inpatient and outpatient hospital account types
• Familiarity with claim edits, 277 rejections, and billing integrity workflows
• Exposure to managed Medicare, managed Medicaid, and commercial financial classes
• Experience with medical records handling and document management tasks