Claims Specialist in Washington

This role requires a 3 month training period in office and must be within commuting distance to the King of Prussia, PA headquarters.

Independence Physician Management (IPM), a subsidiary of UHS, was formed in 2012 as the physician services unit of UHS. IPM develops and manages multi‑specialty physician networks and urgent-status clinics that align with UHS acute‑care facilities. It also provides select services for the Behavioral Health division of UHS. Through continuing growth, IPM operates in 11 markets across six states and the District of Columbia. Our leadership team, practitioners, and teams of healthcare professionals are collectively dedicated to improving the health and wellness of people in the communities we serve.

The Claims Specialist is responsible for the accurate and timely resolution of professional billing claims and clearinghouse edits as well as payer rejections. This includes registration‑based edits, claim requirement data edits (e.g., missing admission date), provider enrollment edits (e.g., missing NPI), and payer‑specific edits. The position meets or exceeds established performance targets (productivity, scheduler quality) set by the Billing Supervisor. Performs root‑cause analysis and identifies edit trends to mitigate lag days, reduce large‑volume claim submission delays, and maximise opportunities to improve process and update the Practice Management System (PMS) logic as needed. Exercises good judgement in escalating identified root causes and edit trends to the Billing Supervisor, as required, to ensure timely resolution and communication to stakeholders. Demonstrates the ability to be an effective team player, upholds best practices day‑to‑day processes and workflow standardisation to drive maximum efficiencies across the team, and communicates effectively with IPM Coders to handle accurate and timely resolution of coding‑based claim edits.

Qualifications

• High School Graduate/GED required. Technical School/2 Years College/Associates Degree preferred.
• Experience (3-5 years minimum) working in a healthcare (professional) billing, health insurance or equivalent operations work environment.
• Healthcare (professional) billing and knowledge of CPT/ICD‑10 coding, claim submission requirements.
• Understanding of the revenue cycle and how the various components work together preferable.
• Excellent organisation skills and attention to detail.
• Service‑oriented/customer‑centric.
• Strong computer literacy skills including proficiency in Microsoft Office and mainframe billing software (e.g., Cerner, Epic, IDX).
• Ability to handle data entry accurately in a high‑paced environment.
• Ability to reconcile data and identify discrepancies.
• Research and problem‑solving ability.
• Results oriented with a proven track record of accomplishing tasks within a high‑performing team environment.

The benefits for IPM employees include:

• A challenging and rewarding work environment
• Competitive compensation & generous paid time off
• Excellent medical, dental, vision, and prescription drug plans
• 401(k) with company match
• and much more!