Senior Claims Specialist - Claims Processing

Description The Senior Claims Specialist is responsible for processing complex institutional claims (stop loss, contracted, non-contracted, per diem, case rate, etc.), adjudication, and claims research when necessary. This role requires knowledge of compliance issues related to claims processing and the ability to identify and address non‑contracted providers. Required Qualifications 2 years of claims pricing and processing experience in ambulatory, acute care hospital, HMO or IPA environments. Experience processing all types of medical claims, including outpatient/inpatient UB‑04 and HCFA‑1500 claims. Preferred Qualifications Experience interpreting provider contract reimbursement terms. Benefits Providence offers a comprehensive benefits package that includes a 401(k) savings plan with employer matching, health care benefits (medical, dental, vision), life and disability insurance, paid parental leave, vacations, holidays, voluntary benefits, and well‑being resources. EEO Statement Providence is an equal opportunity employer. We are committed to providing a workplace free from unlawful discrimination and harassment. #J-18808-Ljbffr Providence Health & Services