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Remote Claims Processing Jobs in Washington (NOW HIRING)

C-MCI

Medical Billing Specialist

Fairfax, VA · On-site +1

$18.50 - $24/hr

Remote / On-site Department: Revenue Cycle Management Overview: CMCI is seeking a detail-oriented and experienced Medical Billing Specialist to oversee claims processing, revenue cycle management ...

Berkley

Claims Representative

Manassas, VA · Remote

Manage the claims litigation process to ensure timely and cost-effective claims resolution * Monitor the expenses and effectiveness of managed care and investigation vendors * Actively participate in ...

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Remote Claims Processing information

What are some common challenges faced in remote claims processing roles, and how can they be effectively managed?

Remote claims processing professionals often encounter challenges such as managing high volumes of claims, maintaining clear communication with team members, and ensuring data security while working from home. Effective time management and strong organizational skills are key to handling large workloads efficiently. Regular check-ins with supervisors and using secure, company-approved communication tools can help maintain collaboration and protect sensitive information. Many organizations also provide training and support to help remote processors stay up-to-date with changing regulations and best practices.

What are the key skills and qualifications needed to thrive as a Remote Claims Processor, and why are they important?

To thrive as a Remote Claims Processor, you need a strong understanding of insurance policies, attention to detail, and relevant experience or education in insurance or finance. Familiarity with claims management software, electronic document systems, and sometimes industry certifications like AIC (Associate in Claims) are typically required. Excellent communication, time management, and problem-solving abilities help you stand out, especially when working independently. These skills ensure accurate, timely claims resolutions and effective collaboration with clients and colleagues in a remote environment.

What is remote claims processing?

Remote claims processing is the evaluation and handling of insurance claims by professionals who work from locations outside of a traditional office, often from home. These processors review claim submissions, verify information, assess coverage, and authorize payments or request additional information. Remote claims processors use secure online systems and communication tools to collaborate with colleagues and clients. This role requires strong attention to detail, confidentiality, and proficiency with digital platforms. Many insurance companies now offer remote claims processing positions to increase flexibility and efficiency.

What is the difference between Remote Claims Processing vs Remote Claims Adjuster?

AspectRemote Claims ProcessingRemote Claims Adjuster
CredentialsTypically requires insurance or claims processing certificationsRequires insurance licenses and adjuster certifications
Work EnvironmentHome-based, administrative settingHome-based or field, investigative and evaluative tasks
Industry UsageInsurance companies, third-party administratorsInsurance companies, public adjusting firms
Job FocusProcessing claims, data entry, customer serviceInvestigating claims, assessing damages, settlement negotiations

Remote Claims Processing and Remote Claims Adjuster roles share similarities in industry and work environment but differ in job focus and required credentials. Claims processors handle administrative tasks and data entry, while claims adjusters evaluate damages and negotiate settlements. Both roles are essential in the insurance industry and often require specialized certifications.

What are popular job titles related to Remote Claims Processing jobs in Washington? For Remote Claims Processing jobs in Washington, the most frequently searched job titles are:
What job categories do people searching Remote Claims Processing jobs in Washington look for? The top searched job categories for Remote Claims Processing jobs in Washington are:
What cities in Washington are hiring for Remote Claims Processing jobs? Cities in Washington with the most Remote Claims Processing job openings:
Remote Claims Processing jobs near you
Medical Billing Specialist

Medical Billing Specialist

C-MCI

Fairfax, VA • On-site, Remote

$18.50 - $24/hr

Full-time

Posted 22 days ago

Job description


Position: Medical Billing Specialist
Location: Remote / On-site
Department: Revenue Cycle Management
Overview:
CMCI is seeking a detail-oriented and experienced Medical Billing Specialist to oversee claims processing, revenue cycle management, and contribute valuable insights to develop AI-powered tools that enhance medical billing workflows. The ideal candidate will have expertise in medical coding, claims submission, payer interactions, and denial management, ensuring optimized billing practices for maximum reimbursement and minimal claim rejections.
Why Join CMCI?
  • Opportunityto work with cutting-edge AI-driven billing solutions that optimizeRCM efficiency.
  • Work in acollaborative environment with healthcare and AI professionals.
  • Competitivesalary, benefits, and professional development opportunities.

Key Responsibilities:
  • ClaimsProcessing & Submission:
    • Accuratelyprocess, review, and submit medical claims.
    • Verify CPT,ICD-10, and HCPCS codes to ensure claims compliance withpayer-specific policies.
    • Work withclearinghouses and insurance payers to track claims and resolve denials,rejections, and underpayments efficiently.
  • Revenue CycleManagement (RCM):
    • Oversee theentire claims lifecycle, from eligibility verification to final paymentreconciliation.
    • Monitoraccounts receivable (A/R) aging reports and ensure timely follow-upon outstanding claims.
    • Optimizepayer reimbursement rates by leveraging contractual agreements andcoding best practices.
  • Payer &Compliance Coordination:
    • Utilize thepayer lookup database to retrieve Payer IDs and transactiontypes for accurate claim submission.
    • Ensurecompliance with Medicare, Medicaid, and private insuranceguidelines to prevent fraud and billing errors.
    • Stay updatedon coding changes, regulatory requirements, and payer policies tomaintain accuracy in claims processing.
  • Technology& AI Development Support:
    • Provideinsights into billing workflows, common claim errors, and automationopportunities to improve AI-driven billing tools.
    • Assist intesting and refining AI-powered RCM solutions, including automated claimsscrubbing and predictive denial management.
    • Collaboratewith the engineering and data science teams to train AI models forenhanced claims accuracy.

Requirements
Required Qualifications:
  • Education& Certification:
    • Associate'sor Bachelor's degree in Health Information Management, Business, or arelated field (preferred).
    • CertifiedProfessional Biller (CPB) or Certified Professional Coder(CPC) (preferred).
  • Experience:
    • 2+ years ofexperience in medical billing, claims processing, or revenue cyclemanagement.
    • Strongknowledge of CPT, ICD-10, and HCPCS coding systems.
    • Experienceworking with Medicare, Medicaid, and commercial insurance payers.
  • TechnicalSkills:
    • Proficiencywith billing and practice management software such as:
      • ElectronicHealth Records Systems: Epic, Cerner, Athenahealth
      • Clearinghouseplatforms: Emdeon, Availity, Change Healthcare, Waystar, Kareo
    • Experiencewith ANSI X12 837 EDI claims processing.
    • Strong Exceland data analysis skills for tracking claim performance.
    • Familiaritywith AI-based RCM tools is a plus.
  • Soft Skills:
    • Stronganalytical and problem-solving skills for identifying claimdiscrepancies.
    • Excellentcommunication and collaboration skills to liaise with providers andpayers.
    • Ability towork independently and in a team environment in a fast-pacedsetting.

Join CMCI to help revolutionize the future of AI-powered medical billing!
All qualified applicants will receive consideration for employment without regard to any characteristic protected by local, state, or federal laws, rules, or regulations

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