ZipRecruiter

Log In

1

Claim Operator Jobs in Washington (NOW HIRING)

CGI Inc.

Management Analyst I - CIVIL

Washington, DC · On-site

$25.72/hr

Ensure claim files are appropriately created in paper and electronic formats according to standard operating procedures. Identify and report duplicate claim entries and quality control issues to ...

Luminis Health

Patient Account Representative

Annapolis, MD · On-site

$17.75 - $23.50/hr

Ability to edit a claim and send/receive claim notes in the billing system. * Competence with ... Experience operating multi-line phone system, fax machine, photocopier, and PC. Experience with ...

MedStar Health

Director Risk Management

Washington, DC · On-site

... implements operating policies and procedures for the MGUH Risk Management Department Reviews ... Ensures thorough timely and ongoing documentation of events and claim activity are entered in CMAPS ...

Pae

Paralegal

Washington, DC · On-site

$25.58/hr

... operating procedures and guidelines, performs the following tasks. * Compiles and prepares supporting documentation for use by claim review attorneys in discovery/preparation of claims processing in ...

Pae

ParalegaI

Washington, DC · On-site

$25.58/hr

... operating procedures and guidelines, performs the following tasks. * Compiles and prepares supporting documentation for use by claim review attorneys in discovery/preparation of claims processing in ...

Amentum

Paralegal

Washington, DC · On-site

$25.58/hr

... operating procedures and guidelines, performs the following tasks. * Compiles and prepares supporting documentation for use by claim review attorneys in discovery/preparation of claims processing in ...

Amentum

ParalegaI

Washington, DC · On-site

$25.58/hr

... operating procedures and guidelines, performs the following tasks. * Compiles and prepares supporting documentation for use by claim review attorneys in discovery/preparation of claims processing in ...

previous page

Showing results 41-60

All JobsClaim Operator JobsClaim Operator Jobs in Washington

Claim Operator information

What are some common challenges a claim operator faces in managing insurance claims, and how can they be addressed?

Claim Operators often encounter challenges such as handling a high volume of claims, ensuring accuracy in documentation, and meeting strict deadlines. These challenges can be managed by developing strong organizational skills, utilizing claims management software efficiently, and maintaining clear communication with both clients and team members. Staying updated on regulatory changes and company policies also helps prevent errors and ensures compliance throughout the claims process.

What is the difference between Claim Operator vs Claims Adjuster?

AspectClaim OperatorClaims Adjuster
Required CredentialsHigh school diploma or equivalent; some roles may require insurance licensesHigh school diploma; licensing or certification often required
Work EnvironmentInsurance companies, claims processing centersFieldwork and office settings, inspecting damages
Employer & Industry UsageInsurance companies, third-party administratorsInsurance companies, independent adjusting firms
Common Search & ComparisonClaim OperatorClaims Adjuster

Claim Operators primarily handle the administrative processing of claims within insurance companies, focusing on data entry and documentation. Claims Adjusters, on the other hand, evaluate damages, inspect claims, and determine settlement amounts. While both roles require insurance knowledge and sometimes licensing, Claim Operators focus on processing, whereas Claims Adjusters are more involved in assessment and decision-making.

What are the key skills and qualifications needed to thrive as a claim operator, and why are they important?

To thrive as a Claim Operator, you need strong analytical skills, attention to detail, and a foundational understanding of insurance processes, often supported by a high school diploma or equivalent. Familiarity with claims management software, Microsoft Office Suite, and sometimes industry certifications like AIC (Associate in Claims) are typically required. Excellent communication, organization, and problem-solving abilities help in interacting with clients and resolving claims efficiently. These skills are crucial for accurately processing claims, ensuring customer satisfaction, and maintaining compliance with regulatory standards.

What does a claim operator do?

A Claim Operator is responsible for processing and managing insurance claims. They review claim submissions, verify documentation for accuracy, and determine the validity of claims according to company policies. Claim Operators may also communicate with clients, adjusters, and other stakeholders to gather additional information or resolve issues. Their role helps ensure that claims are handled efficiently and fairly, contributing to customer satisfaction and the integrity of the insurance process.
What are popular job titles related to Claim Operator jobs in Washington? For Claim Operator jobs in Washington, the most frequently searched job titles are:
What job categories do people searching Claim Operator jobs in Washington look for? The top searched job categories for Claim Operator jobs in Washington are:
What cities in Washington are hiring for Claim Operator jobs? Cities in Washington with the most Claim Operator job openings:
Claim Operator jobs near you

Patient Accounts Representative II

Howard University Hospital

Washington, DC • On-site

$20.50 - $27/hr

Full-time

Medical, Retirement, PTO

Re-posted 9 days ago

Howard University Hospital rating

7.6

Company rating: 7.6 out of 10

Based on 8 frontline employees who took The Breakroom Quiz

255th of 1,055 rated hospitals

Job description

Description
Patient Accounts Representative II
Howard University Hospital | Washington, DC
Role Summary
As a Patient Accounts Representative II at Howard University Hospital, you will play a critical role in the financial health of our institution - ensuring that the care our clinicians deliver is properly billed, accurately paid, and compliantly documented. Reporting to the Manager of Patient Accounts, you will manage hospital accounts from claim creation through final adjudication, working third-party payers, government programs, and managed care plans to resolve unpaid balances and protect Hospital revenue.
If you bring deep experience in hospital billing and collections, an eye for detail, and the persistence to work claims to resolution, this is your opportunity to contribute to the financial sustainability of one of the nation's most storied academic medical centers.
What You'll Do
Account & Insurance Management
  • Review and update patient account insurance information, ensuring third-party payer information is complete and accurate
  • Enter and update patient, insurance, contract, revenue, and reimbursement data into one or more hospital applications
  • Verify insurance eligibility and covered services to support accurate claim creation and timely adjudication

Billing & Claims
  • Prepare and submit hardcopy and electronic billing claim packages, collecting all necessary materials for proper claim creation and modification
  • Make payer-specific data changes as required for accurate, compliant, and timely billing
  • Verify that payments and account balances align with payer contracts and applicable billing rules and regulations

Collections & Denial Resolution
  • Contact insurance carriers as scheduled by the collection tool; communicate clear action plans when adjudication is delayed
  • Identify, review, and resolve denied claims daily; monitor accounts receivable status using Siemens Invision Unity, ePremis, EDM, the Medicaid and Medicare portals, CareFirst, and MCO portals
  • Perform payer remittance and reimbursement posting reconciliation; ensure reimbursement is consistent with payer contractual terms before performing adjustments or billing patient responsibility
  • Review and resolve credit balances accurately; report out-of-the-ordinary circumstances to immediate supervisors for investigation

Customer Service & Documentation
  • Receive and respond promptly to internal and external phone calls, correspondence, and inquiries related to patient accounts
  • Prepare and maintain supporting data and documents on all required activities within the hospital system as defined by departmental guidelines

Compliance & Regulatory
  • Promote adherence to the Health Sciences Compliance Program, the Howard University Code of Ethics, the Health Sciences Standards of Conduct, and HIPAA
  • Attend annual and periodic mandatory compliance training, including HIPAA Privacy training; actively participate in compliance program activities
  • Participate in activities that promote adherence to federal healthcare program requirements
  • Maintain strict confidentiality of patients, families, and staff

Required Qualifications
  • High School Diploma or General Equivalency Diploma (G.E.D.) required
  • Minimum of five (5) years of experience in billing, collections, customer service, or cash posting required
  • Hospital setting experience required
  • Acute care facility experience required, including inpatient stay collection, DRG reimbursement, and Medicare and Medicaid payer experience
  • Certified Patient Account Representative (CPAR - HFMA) or Certified Revenue Cycle Specialist - Institutional (CRCS-I - AAHAM) certification required, and must be retained throughout employment
  • Demonstrated ability to produce accurate Medicare, Medicaid, and commercial payer claims that yield substantiated reimbursement
  • Proficiency in Microsoft Office (Outlook, Excel, Word, PowerPoint); strong basic computer and math skills
  • Strong organization, problem-solving, and time-management skills; ability to work independently in a collaborative environment

What We Offer
  • Work-life balance
  • Recognition and rewards for professional expertise
  • Competitive, comprehensive benefit plans including health, disability, vacation, sick leave, and 403(b) retirement plan
  • Tuition remission at Howard University for you and/or eligible dependent children - up to two (2) courses per semester
  • A mission-driven environment rooted in over 150 years of excellence, service, and advocacy for the communities we serve

About Howard University Hospital
Howard University Hospital (HUH) is the nation's only teaching hospital located on the campus of a historically Black university. With a legacy dating back to 1862 - when it operated as Freedmen's Hospital, providing care and refuge to those who had been denied it elsewhere - HUH has grown into one of the most comprehensive healthcare facilities in the Washington, D.C. metropolitan area and is a designated DC Level 1 Trauma Center. Today, HUH continues its proud tradition of delivering exemplary, patient-centered, and culturally responsive care to the community, while providing exceptional learning and professional development opportunities for the next generation of healthcare professionals.
Position Details
DepartmentPatient AccountsReports ToManager, Patient AccountsFLSA StatusNon-ExemptBargaining UnitLocal 2094ScheduleFull-Time | Monday - Friday, 8:00 AM - 4:30 PM
Pay & Schedule
This is a full-time, non-exempt position covered under the Local 2094 collective bargaining agreement. Pay range: $19.00 - $30.40/hr, commensurate with experience and qualifications.
Compliance Statements
Culture of Care: Howard University Hospital supports a Just Culture that promotes accountability, learning, and patient safety.
Equal Opportunity Employer: Howard University Hospital is an Equal Opportunity Employer. We are committed to creating an inclusive environment for all employees and applicants and do not discriminate on the basis of race, color, religion, sex, national origin, age, disability, veteran status, sexual orientation, gender identity, or any other status protected by applicable law.
Reasonable Accommodation: Howard University Hospital is committed to providing reasonable accommodations to qualified individuals with disabilities in accordance with the Americans with Disabilities Act (ADA) and applicable state and local laws. If you require an accommodation during the application or interview process, please contact the Human Resources Department at HUHLA@huhosp.org.
Pay Transparency: Salary ranges listed in job postings reflect the expected compensation range for the position and are provided in accordance with applicable pay transparency laws. Final compensation is determined based on experience, education, internal equity, and other relevant factors.
Disclaimer: The above statements describe the general nature and level of work performed. They are not intended to be an exhaustive list of all duties, responsibilities, or qualifications associated with the position.

What Howard University Hospital employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

Apply