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$21/hr–$33/hr
Full-time
high school
Retirement 401(k) Savings Plan, Health care benefits, Medical insurance, Dental insurance, Vision insurance, Life insurance
Posted 45d ago
~40 hrs/week
Responsibilities
The Claims Specialist is responsible for accurately reviewing, processing, and adjudicating TRICARE medical claims in compliance with regulations and company policies. They also investigate claim discrepancies and resolve inquiries from providers and beneficiaries to ensure high-quality service.
Requirements
Candidates must have a high school diploma or GED and at least two years of experience in managed care operations. Additionally, one year of claims processing experience in a TPA, MSO, HMO, PHO, or large group practice setting is required.
Full job description
The Claims Specialist is responsible for reviewing, processing, and adjudicating TRICARE medical claims accurately and in accordance with TRICARE regulations, contract requirements, and company policies. This role investigates claim discrepancies, resolves provider and beneficiary inquiries, ensures compliance with healthcare reimbursement guidelines, and maintains high standards for quality and turnaround times.
Providence caregivers are not simply valued – they’re invaluable. Join our team at Pacmed Clinics DBA Pacific Medical Centers and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them.
Required Qualifications:
H.S. Diploma or GED, or equivalent experience in Health Care Business Administration.
2 years in Managed Care operations.
1 year claims processing experience, in a TPA, MSO, HMO, PHO or large group practice setting.
Experience with areas of specialty claim processing (COB, Adjustments, Point of Service, Home Health and Encounters).
Information systems supporting the administration of managed care products.
Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security. We take care of you, so you can focus on delivering our mission to advocate, educate and provide extraordinary care.
Accepting a new position at another facility that is part of the Providence family of organizations may change your current benefits. Changes in benefits, including paid time-off, happen for various reasons. These reasons can include changes of Legal Employer, FTE, Union, location, time-off plan policies, availability of health and welfare benefit plan offerings, and other various reasons.
At Providence, our strength lies in Our Promise of “Know me, care for me, ease my way.” Working at our family of organizations means that regardless of your role, we’ll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable.
Posted are the minimum and the maximum wage rates on the wage range for this position. The successful candidate's placement on the wage range for this position will be determined based upon relevant job experience and other applicable factors. These amounts are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.
Providence offers a comprehensive benefits package including a retirement 401(k) Savings Plan with employer matching, health care benefits (medical, dental, vision), life insurance, disability insurance, time off benefits (paid parental leave, vacations, holidays, health issues), voluntary benefits, well-being resources and much more. Learn more at providence.jobs/benefits.
Pacific Medical Centers (PacMed) is a private, not-for-profit, primary and integrated multi-specialty health care network with outpatient clinics and primary and specialty care providers in King, Snohomish and Pierce counties. We combine decades of patient-centered care with cutting-edge technology, first-class facilities and board-certified providers.
Our strong team environment and respect for our people—at all levels and from all backgrounds—allow us to provide authentic care that achieves the highest-quality patient outcomes, backed by the strong network of resources and support through our affiliation with the Providence family, including local partners like Swedish Health Services.
Providence is proud to be an Equal Opportunity Employer. We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law. We believe diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement.
For any concerns with this posting relating to the posting requirements in RCW 49.58.110(1), please click here where you can access an email link to submit your concern.
How many Healthcare jobs are open in Renton, WA right now?
There are currently 220 open healthcare positions in Renton, WA listed on Clera. New openings are added daily as companies post roles.
Which companies are hiring for Healthcare roles in Renton, WA?
Companies currently hiring include PROVIDENCE MEDICAL INSTITUTE, Kaiser Permanente Oakland Medical Center, Proliance Surgeons, UW Medicine, SpringHealth Behavioral Health & Integrated Care, among others. Browse the listings above to see every active employer.
Are there remote or hybrid Healthcare jobs in Renton, WA?
Yes — 43 of the 220 open healthcare positions offer remote or hybrid work (11 remote, 32 hybrid).
How do I apply for Healthcare jobs in Renton, WA?
Each listing links directly to the employer's application page. Apply early — fresh listings get the most recruiter attention in the first two weeks.