Claims Processor

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 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 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. #J-18808-Ljbffr