Medical Claims Processor (Contract-to-Hire)

Location: Seattle, WA | Federal Way, WA | Mountlake Terrace, WA
Schedule: Hybrid (Training Onsite)
Pay: $28.20-$32.46/hour
Job Type: Contract-to-Hire

About the Opportunity

Medical Claims Processor (Contract-to-Hire)

Location: Seattle, WA | Federal Way, WA | Mountlake Terrace, WA
Schedule: Hybrid (Training Onsite)
Pay: $28.20-$32.46/hour
Job Type: Contract-to-Hire

About the Opportunity

Medix is seeking experienced Medical Claims Processors for a growing healthcare organization. This is an excellent opportunity to join a stable team with long-term career potential, competitive pay, and the ability to transition to a hybrid work schedule after training.

We're looking for detail-oriented professionals with experience processing medical claims in a payer environment or candidates with strong provider-side medical billing and revenue cycle experience.

Responsibilities

• Review and process medical claims according to benefit and eligibility guidelines.

• Determine claim outcomes by paying, pending, or denying claims based on established processing criteria.

• Review medical claims received through EDI and ensure accurate, timely processing.

• Verify benefits, eligibility, and Coordination of Benefits (COB) information.

• Request additional documentation when necessary to support claims processing.

• Utilize administrative guidelines and internal resources to ensure accurate adjudication.

• Process claim referrals and resolve outstanding claim issues in a timely manner.

• Maintain production and quality standards in a high-volume environment.

• Update member insurance information and enrollment records as needed.

• Stay current on claims processing guidelines, policies, and procedures.

Qualifications

Required

• At least 1 year of medical claims processing experience with a health plan, insurance carrier, TPA, or other payer organization.

• Candidates with strong provider-side medical billing or revenue cycle experience are also encouraged to apply.

• Working knowledge of:

  • Medical claims processing

  • CPT and diagnosis coding

  • HIPAA regulations

  • Coordination of Benefits (COB)

  • Benefits and eligibility verification

  • Medical record interpretation

• Intermediate Microsoft Excel skills.

• Strong computer proficiency and ability to navigate multiple systems.

• Excellent attention to detail and organizational skills.

• Strong written and verbal communication skills.

Preferred

• 5+ years of medical claims processing experience.

• Experience working in a production-based claims environment with quality and productivity metrics.

Schedule

• Monday-Friday

• Full-time

• Initial 6-8 weeks onsite for training

• Employees remain onsite until production and quality standards are met.

• Eligible to transition to a hybrid schedule (3 days onsite/2 days remote) once performance expectations are achieved.

• Core operational hours are 10:00 AM-3:00 PM, with flexible start times available as early as 7:00 AM after training.

Applicants may choose to work from one of the following office locations:

• Seattle

• Federal Way

• Mountlake Terrace

What We're Looking For

The ideal candidate is highly organized, analytical, and thrives in a fast-paced production environment. You have a strong understanding of medical claims, enjoy problem-solving, and consistently deliver accurate work while meeting productivity goals.

Pay

$28.20-$32.46 per hour

This is a contract-to-hire opportunity offering long-term career growth with excellent benefits available upon permanent hire, including medical, dental, vision, retirement, paid time off, and a hybrid work environment.

We're looking for detail-oriented professionals with experience processing medical claims in a payer environment or candidates with strong provider-side medical billing and revenue cycle experience.

^*We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state, and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO), and the California Fair Chance Act (CFCA).

^*As a job position within our Insurance division, a successful completion of a background check may be required as a condition of employment. This requirement is directly related to essential job functions including but not limited to: accessing medical and confidential records, verifying financial information, and working within departments that care for vulnerable populations, such as, minors, elderly and those with physical or mental disabilities. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients