111 Results for

Claims Specialist Jobs in Washington, DC

Jobs

New!

Bethesda, MD3 days ago

Remote

$18–$18 Per Hour

Analytical and interpretive skills Strong organizational skills Good interpersonal skills Ability to multitask in a fast-paced environment Ability to support multiple clients across communication channels and utilize multiple systems simultaneously Ability to work in a team environment and/or independently. The Service Center Representative expedites the claims process and provides detailed claim notes on all calls; as well as resolves issues and directs calls to an appropriate escalation path as needed.

Odenton, MD25 days ago

$110,000–$140,000 Per Year
Full-time
Employee

CONSIDERED EXPERIENCE INCLUDES: Insurance Claims Specialist Adjuster Examiner Analyst Attorney Environmental Toxic Tort Asbestos Pollution Health Hazard #DiedreMoire #JobSearch #JobHunt #JobOpening #Hiring #Job #Jobs #Careers #Employment #jobposting #InsuranceJobsDISCLAIMER: We will make every effort to consider applications for all available positions and shall use one or more of the contact methods and addresses indicated in resume or online application. Diedre Moire CorporationEducation Requirements: Bachelor DegreeMinimum Experience Requirements: 5-10 yearsJob City Location: OdentonJob State Location: MDJob Country Location: USASalary Range: $110,000 to $140,000.

MD10 days ago

Remote

$28.76–$48.96

Handles complex coding case review including but not limited to surgical coding (Orthopaedics Cardiac Neurosurgery Otolaryngology etc.) extraction, co-surgery scenarios, multi-visceral transplant cases, comorbidity evaluation. In addition to interacting with physicians on coding issues, ensures that physician encounter forms, the GE IDX billing system and processes are up to date and compliant regarding coding issues.

Herdon, VA30+ days ago

Remote

Must be able to implement critical thinking and decision making skills in order to identify appropriate care/treatment plans for a wide range of members from low to high complexity. Our service and solution delivery starts with understanding each client’s end-state, and then seamlessly integrating within each Agency’s organization to improve and enhance business and technical operations and deployments.

Waldorf, MD14 days ago

$64,965.62–$99,000 Per Year

Competitive candidates should reside within one of the listed zip codes and will service this same territory: 20701 20705 20706 20708 20710 20715 20716 20720 20721 20724 20737 20740 20742 20755 20769 20770 20771 20781 20783 20784 20785 21114 21054 20001 20099 20201 20599 20601 20603 20607 20608 20613 20616 20623 20695 20711 20714 20733 20735 20736 20744 20745 20746 20748 20751 20754 20758 20762 20764 20765 20772 20774 20776 20778 20779 20602 20611 20612 20617 20622 20637 20639 20640 20646 20658 20675 20677 20678 20689 20732. With the opportunity to initially earn up to 20 days annually plus parental leave, paid holidays, celebration day, life leave (40 hours/year), bereavement leave, and community service/education support days, there will be plenty of time for you!

Hanover, Maryland30+ days ago

Prepares for and attends Claim Review Conference with TPA to evaluate individual cases; reviews, and adjusts financial reserves of claims; negotiates with TPA the settlement of claims within established authority and work together to develop detailed and doable Plans of Actions. Reporting to the Workers Compensation Compliance Supervisor and Workers Compensation Compliance Manager, the Claims Review Specialist will assist in the monitoring and administering of Aerotek's workers compensation program to ensure the maximum cost containment.

Washington, DC30+ days ago

Remote

$223,800–$313,100 Per Year

The Medical Director may speak with contracted external physicians, physician groups, facilities, or community groups to support regional market priorities, which may include an understanding of Humana processes, as well as a focus on collaborative business relationships, value-based care, population health, or disease or care management. The Medical Director’s work includes computer-based review of moderately complex to complex clinical scenarios, review of all submitted clinical records, prioritization of daily work, communication of decisions to internal associates, and possible participation in care management.

College Park, Maryland11 days ago

$24–$28 Per Hour

Baltimore, MD30+ days ago

Remote

Full-time

Proficient with claim and coding tools such as Supercoder, Clinical Decision Support Tool, Current Procedural Terminology, Health Care Financing Administration Common Procedure Coding System, and American Dental coding. This role will serve as a SME and will collaborate with Claims leadership, Training, the Claims Content Specialist, and internal business partners to ensure procedures and training materials are accurate and complete.

Springfield, VA30+ days ago

This position works under general supervision while conducting customer service activities to receive, process, analyze, and resolve household goods cargo, property, and inconvenience claims and claim-related matters filed by our customers. Prepare claim settlement offers in a written format and submit them to the customer within the prescribed time allotted, while trying to consistently reduce the overall number of outstanding claims and amount spent.

Fairfax, VA26 days ago

Full-time

Establish reserves, using independent judgment and expertise and authorizes payments within scope of authority, settling claims in the most cost effective manner and ensuring timely issuance of disbursements. We're seeking an experienced Claims Adjuster who excels at handling advanced, large-loss, and complex cases, with the independence to make sound decisions and the expertise to deliver fair, timely outcomes.

Baltimore, MD30+ days ago

$21–$21 Per Hour

FDSP Associates is the organization that provides patient care focused staffing for the clinic operations so that faculty and students may provide patient care to the general public. Coordinate with dental providers to obtain necessary information (i.e. narratives, treatment notes) in order to submit accurate claims and to resolve disputes/appeals.

Linthicum Heights, MD30+ days ago

$95,000–$105,000 Per Year

This position supports operations and requires conducting safety inspections, monitoring crew activities for compliance, ensuring proper use of PPE, maintaining EHS documentation, and supporting safe convoy access onto and off the bridge with the team each shift. With targeted direction, this position is responsible for monitoring compliance with federal, state, and local requirements, maintaining accurate documentation, and partnering with operational teams to implement best‑practice safety programs.

New!

Glen Burnie, MD3 days ago

As a Medical Collections Specialist, you will play a key role in resolving claim denials, researching account issues, communicating with insurance carriers, and ensuring claims are processed accurately and efficiently. This role is ideal for someone who enjoys problem solving, working with insurance carriers, and helping drive the success of the revenue cycle process in a fast paced healthcare environment.

Baltimore, Maryland14 days ago

Mercy Medical Center is honored to be recognized by Newsweek as one of America's Most Trustworthy Companies for three consecutive years (2023–2025) and as one of America's Greatest Workplaces for Women in 2025. Ensures the hospital bills a clean claim to the correct third party payor so that the turn around time for payment is minimal and a positive cash flow is maintained for the hospital.

Manassas, Virginia30+ days ago

This position directly contributes to loss cost management, improved recovery outcomes, and an elevated customer experience by reducing disability duration and supporting early, collaborative return‑to‑work solutions. The role serves as a strategic partner to employers, injured workers, medical providers, and internal claims teams, ensuring that modified duty opportunities are identified, communicated, and implemented effectively.

Linthicum Heights, MD10 days ago

The ideal consultant brings strong CPT coding expertise, urology experience, and the ability to manage detailed research and triage inquiries efficiently. Insurer Relations & Payment PolicyProvide strategic advice and technical support on insurance coverage, payment policy, and payer issues.

Maryland30+ days ago

Remote

$20.57–$36.27 Per Hour

Collects insurance accounts by contacting insurance carriers and other third party payers to verify receipt of billing and other information needed to process claims secure approximate date of payment negotiate with claims personnel for prompt payment and resolve discrepancies in billings within appropriate time frames. Under general supervision performs accounts receivable follow-up/collection procedures to obtain timely reimbursement from third party carriers and other payment sources on moderately complicated invoices in a Direct Contract assignment and/or with an invoice balance.

Columbia, MD30+ days ago

Review paid claims, identify claims that meet No Surprises Act requirements, retrieve documents for NSA submissions, initiate NSA submissions, work with 3rd party vendors, maintain logs, and meet all Federal and State deadlines. + Ensures Compliance with applicable governmental laws, rules, and regulations, both in the United States and internationally, by completing introductory and annual training and maintaining knowledge of compliance as it applies to your role.

New!

Washington, DC4 days ago

$65,000–$75,000

This individual will work closely with the Director of Business Operations and Director of Revenue Operations to ensure that cash pay invoicing, contracting, and insurance claims are accurate, timely, and reimbursed in full. Manage extension requests and contracts, including communication with clients and guarantors regarding billing questions and account needs.

Manassas, VA30+ days ago

Part-time

Duties include: managing vehicle storage; assessing vehicle condition; coordinating repairs; gathering pertinent data points to place in orders; communicating with customers and vendors by phone and email; establishing strong relationships with customer contacts and vendors; conducting quality checks; and assisting with any additional tasks and responsibilities as may be deemed necessary by management. Working with a customer to understand every pain point, PARS develops a metrics-driven solution that can combine any or all of its services — vehicle driveaway, auto carrier service, storage management, license and titling, reconditioning & make-ready, detailing, body work, mechanical repair, and general maintenance services.

Washington, DC30+ days ago

Prepare and provide feedback on procurement packages, including preparation and review of requirements documentation (e.g., Statements of Work (SOWs), Statements of Objectives (SOOs), Statements of Need (SON), PWSs, market research documentation, independent government cost estimates (IGCEs), draft evaluation factors, applicable pre-award determinations and findings, and applicable pre-award clearances and reviews (Small Business Set-Aside Review and Information Technology Checklist, etc.). Experience independently preparing, briefing, routing and obtaining government clearances for acquisition documents (such as acquisition plans, solicitations, awards, justifications to limit competition, combined synopsis/solicitations), and completing other review processes in a timely fashion.

Annapolis, MD30+ days ago

$20–$27 Per Hour

Acts as a liaison with patients, other departments and fellow Patient Financial Services (PFS) teammates to obtain information related to claims processing and payment. If the use of arm and/or leg controls requires exertion of forces greater than that for sedentary work and the worker sits most of the time, the job is rated for light work.

Washington, DC30+ days ago

$60,000–$70,000 Per Year

We recently closed our Series A with top-tier investors including TTV Ventures, Fika Ventures, Bling Capital, Liquid2 Ventures, Cambrian Ventures, and Max Ventures - firms that have collectively backed 20+ unicorns like Square, Lyft, and Rippling. Sunbound is building the financial OS for senior living: the first modern platform that manages the entire payments process end-to-end, saving operators time, reducing costs, and removing unnecessary stress for families.

Silver Spring, MD24 days ago

Remote

Full-time

Additional benefits that include company-paid basic life insurance; short-and long-term disability insurance; orthodontic coverage for children and adults; adoption assistance; fertility and infertility coverage; well-being programs; paid volunteer hours for service to your community; and dollar-for-dollar matching of your charitable gifts each year. *This range represents a national range and the actual salary will depend on several factors including the scope and complexity of the role and the skills, education, training, credentials, location (State) based on ERIE's geographical differences, and experience of an applicant, as well as level of role for which the successful candidate is hired.

Odenton, MD30+ days ago

Full-time

Must have experience working directly for a private practice, not a hospital or billing company, doing billing, coding, charge entry, and AR work only. We are a well-established specialty surgery group focused on helping patients live pain-free, active lives.

Baltimore, MD30+ days ago

We are seeking a detail-oriented and highly motivated Patient Accounts Specialist – Collections to join our Patient Financial Services team at a leading healthcare system in Baltimore. This role is ideal for professionals with a strong background in hospital collections, excellent analytical skills, and a passion for delivering outstanding patient service.

Fairfax, VA30+ days ago

Collaborates appropriately with internal cross functional partners including but not limited to Associate Director Regional Marketing, Oncology Field Reimbursement Managers, and other specialty roles to facilitate aligned, coordinated efforts with Customers in a compliant manner. Experience working with key laws and regulations impacting the pharmaceutical industry (e.g., PhRMA Code; Federal Food, Drug, Cosmetic Act; Anti-Kickback Statute; False Claims Act, OIG/DOJ Guidance; Foreign Corrupt Practices Act; and federal and state transparency and disclosure laws) preferred.

Baltimore, MD25 days ago

Remote

Full-time

Technical Skills: Knowledge of TRICARE policies and procedures, knowledge of Case Management, Utilization Management, and Quality Management practices and principles, and knowledge of Managed Care concepts, alternative care treatments, and community resources. • Research and investigate medical issues as they relate to potential fraud and abuse cases, to include perform anti-fraud and abuse pre-payment reviews or post-payment reviews.

Annapolis, MD30+ days ago

$33–$42 Per Hour

Working closely alongside the denial management department, the coding denial analyst is a liaison between coding and the business office and communicates issues with missing documentation, inaccurate coding, and other trends causing denials. The coding denial analyst supports the denial management team by reviewing claims denied for coding-related root causes, as well as suggesting process improvements to reduce future denials.

Tysons, VA26 days ago

Full-time

Maximus compensation is based on various factors including but not limited to job location, a candidate's education, training, experience, expected quality and quantity of work, required travel (if any), external market and internal value analysis including seniority and merit systems, as well as internal pay alignment. If you require assistance at any stage of the employment process-including accessing job postings, completing assessments, or participating in interviews,-please contact People Operations at applicantaccom@maximus.com.

Baltimore, MD25 days ago

Full-time

The incumbent will also work closely with MTF staff to support TRICARE beneficiaries and provide non-clinical support for patient referrals and authorizations; outreach to network providers as necessary; and to facilitate the support of applicable TriWest departments for resolving network gaps, provider and contract concerns, customer service requests, and discharge coordination for patients from network and non-network facilities. • Performs on-site and virtual outreach activities for military installation community and beneficiary groups such as Family Readiness Groups, Retiree Associations, and Installation New-comers Orientation, and provides educational briefings on such matters as transferring TRICARE enrollment, PCM selection, and other interest areas for new people to the community.

Baltimore, MD25 days ago

Remote

Full-time

Technical Skills: Proficient with key databases, including FoxPro, Claims Systems, Medical Management Systems, and Provider Data Management Systems; working knowledge of VA policies and procedures, current knowledge of claims, reimbursement methodology; healthcare or managed care experience. • Communicate clearly through both written and verbal forms of communication and follow up with various parties to ensure tasks are completed within the allotted timeline or issues are escalated appropriately.

Washington, DC30+ days ago

$26.93–$40.98 Per Hour

This role plays a key part in CMS Stars initiatives, including but not limited to medication adherence, MTM (Medication Therapy Management), SUPD (Statin Use in Persons with Diabetes), and other targeted projects aimed at improving CMS Star Ratings. + Frequent interactions with providers, colleagues, customers, patients/clients and visitors that require employee to verbally communicate as well as hear and understand spoken information, needs, and issues quickly and accurately.

Washington, DC26 days ago

Remote

Full-time

Job Title: Risk Adjustment Coding Specialist Location: Remote (primarily remote; onsite once a quarter or as needed) Type: Contract to Hire Job Summary: We are seeking experienced and certified Medical Coders to join our Special Investigation Unit (SIU) at CareFirst. We provide a wide array of experienced business and IT professionals supporting clients from solution design to implementation and support.

Maryland12 days ago

$18.70–$32.72 Per Hour

The team works closely with other internal MedStar Health departments including advocacy, CFC and billing to ensure patients who receive retro-eligible Medicaid are billed timely and within the specific state requirements. 1-2 years' Experience in patient accounting, accounts receivable or related healthcare field required or an equivalent combination of experience and college education in accounting, finance or healthcare administration required.

Alexandria, VA13 days ago

Remote

Integrity Management Services, Inc. (IntegrityM) is an award-winning, women-owned small business specializing in assisting government and commercial clients in compliance and program integrity efforts, including the prevention and detection of fraud, waste and abuse in government programs. The Medicaid Audit and Compliance Specialist will perform audits as assigned which consist of but are not limited to performing licensing and exclusion reviews on providers and work with the medical staff to ensure services are reimbursed meet regulatory requirements.

New!

Alexandria, VA5 days ago

Remote

Greenbelt, MD20 days ago

Additionally, the Fraud Specialist position is responsible for ensuring compliance with the Bank Secrecy Act (BSA)/Anti-Money Laundering (AML) policies and procedures and the applicable federal regulations to protect the Credit Union from being used as a conduit for illegal and/or fraudulent activity. This role plays a critical part in protecting member assets, reducing financial losses, and maintaining trust by identifying suspicious transactions, conducting thorough investigations, and ensuring compliance with applicable laws and regulations.

Rockville, MD30+ days ago

Remote

Established in 2008 and based in the Washington Metro Area, OBAN Corporation is a Service-Disabled, Veteran-Owned, Small Business (SDVOSB) and Small Business Administration 8(a) Program Participant that provides practical, strategic, and tactical management solutions to public and private sector clients. Conduct quality review for all recruitment products, i.e., ensure that all job analysis, vacancy announcements questionnaires, qualification determinations, certificates of eligibility, etc., are accurate and based on appropriate OPM, HHS, and FDA policies and regulations prior to issuance of job offer letters.

Tysons (McLean), Virginia30+ days ago

Remote

$67,981–$95,276 Per Year

Employees do not have to pay premiums if they enroll in the Aetna High Deductible Health Plan or the Kaiser HMO Plan; 15 days paid vacation and 13 holidays per year plus 2 volunteer days per year; Generous sick and bereavement leave; Competitive parental leave; Company-paid coverage for long term disability, life insurance, and accidental death & dismemberment; Flexible Spending and Health Savings accounts; Retiree health plan and a retiree health account (retiree HRA). The Air Line Pilots Association, International (ALPA), the largest airline pilot union in the world and the largest non-governmental aviation safety organization in the world (representing over 80,000 pilots at 42 U.S. and Canadian airlines) seeks an experienced Trust Services Account Specialist for our office in Tysons (McLean), Virginia.

Silver Spring, Maryland11 days ago

Annapolis, MD30+ days ago

Remote

$113,000–$120,000 Per Year

Product Specialist , you will make an impact by configuring and maintaining QNXT systems to support provider contracts, benefits, and fee schedules. Regardless of your working arrangement, we are here to support a healthy work-life balance through our various wellbeing programs.

Sterling, Virginia13 days ago

Join Allied Universal as an Unarmed Patrol Officer at a dynamic food and beverage location, where you will conduct routine patrols, remain visible to help discourage security-related incidents, and support access activities with strong customer service and communication. Monitor access points and help to deter unauthorized entry, trespassing, and other security-related concerns involving employees, visitors, and delivery personnel.

New!

Sterling, Virginia6 days ago

Join Allied Universal as an unarmed patrol officer at a dynamic tech location, where you will monitor assigned areas, conduct routine patrols, remain visible to help discourage security-related incidents, and deliver outstanding customer service and communication. Support day-to-day operations by communicating clearly with personnel on site, following post orders, and reporting maintenance, lighting, and/or property concerns that could affect security-related operations.

Annapolis, MD30+ days ago

$83,200–$124,800 Per Year

The clinical denial appeals specialist also works to prevent future clinical denials by communicating with clinical and revenue cycle leadership about denial root causes, such as documentation gaps or insufficient charge capture, and helps develop and implement staff education and process changes. Certification in at least one of the following preferred: certified healthcare chart auditor, certified professional in utilization review (or utilization management or healthcare management), certified case manager, certified documentation specialist, certified coder, certified professional medical auditor, or similar program.

Alexandria, VA30+ days ago

Full-time

That’s why we’ve built a culture where ambitious professionals can excel — supported by advanced digital tools, hands-on mentorship, and a team environment grounded in trust, collaboration, and integrity. This position goes far beyond managing policies — it’s about creating genuine connections, educating families on their options, and becoming a trusted resource they can rely on for years to come.

Laurel, MD30+ days ago

The employee will be regularly required to: Stand; Walk; Use hands and fingers to handle or feel; Reach with hands and arms (including reaching overhead); Talk and hear; Visual ability to read instructions and perform responsibilities; Stoop; Kneel; Crouch; Climb (including use of a 6’ ladder); Balance; Lift and carry up to 25 pounds (including occasional lifting of up to 50 pounds); Push and pull a wheeled demonstration cart fully laden with appliances, supplies and product; Prepare foods using raw products (e.g., meats, poultry), using cooking utensils such as knives, convection oven, coffee maker, electric fryer, microwaves; Be in contact with cleaning supplies. • Ability to prepare and serve food samples using small appliances such as microwaves, fryers, skillets, coffee makers and knives.

Washington30+ days ago

This includes managing resident billing, handling collections, resolving account discrepancies, coordinating legal action when necessary, and ensuring timely payments to support the property's financial stability. Overview: The Community Account Specialist is responsible for overseeing the full accounts receivable process for their assigned portfolio.

Washington, DC30+ days ago

Full-time

REQUIRED EXPERIENCE / SKILLSEducational experience may be substituted in lieu of one year of experience conducting legal research; preparing and reviewing legal documents / briefings and other memorandum; experience analyzing legal documents; and utilizing a variety of forums to conduct research of various laws. In this role, you will prepare certified administrative records for federal court, process and docket Medicare appeals, maintain case files in DABACTS and e-Filing systems, and coordinate with HHS contractors to obtain or complete case files.

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Claims Specialist Jobs in Washington, DC

Jobs

Remote Claims SpecialistNesco Resource

Insurance Claims EnvironmentalDiedre Moire Corp.

Coding Specialist III - Plastics/Podiatric SurgeryMedStar Health

Dental Claims Resolution SpecialistBDR Solutions LLC

Claim Specialist - Property Field InspectionState Farm

Claims Reviews Specialist (Workers Compensation)Aerotek

Medical Director - Claims ManagementHumana

Claims Investigator - Part-TimeAllied Universal

Sr Claims ReviewerTriWest Healthcare Alliance

Claims ExaminerAEM Inc

Sr Claim Examiner- WCCrawford & Company

Dental Clinical Insurance Specialist in the Specialty Clinics Position Control Number CIS-22-110-01U M FDSP Associates PA

EHS Compliance Specialist with F.D. Thomas, Inc.ASRC Industrial

Medical Collections Specialist (In Person Position)Medbridge Healthcare

AR Specialist/CreditsMercy Medical Center

Return to Work SpecialistBerkley

Coding & Reimbursement SpecialistSparks Group

Patient Accounts Specialist II - Physicians BillingMedStar Health

NSA Billing & Collections SpecialistGlobus Medical, Inc.

Billing & Reconciliation SpecialistRelease Recovery

Storage Inventory SpecialistRPM

Contract Specialist / Acquisition Support SpecialistTenacious Solutions

Patient Accounts SpecialistAnne Arundel Medical Center

Revenue Cycle SpecialistSunbound

Liability SpecialistErie Insurance

Medical Billing Specialist / AR Specialist Odenton MDHEALTHCARE RECRUITMENT COUNSELORS

Patient Account SpecialistTap Growth ai

Sr. Oncology Sales Specialist- S1 - (Fairfax, VA) (field based)Eisai

Program Integrity Clinical Specialist (RN or PA Req'd)TriWest Healthcare Alliance

Coding Denials and Appeals SpecialistAnne Arundel Medical Center

Reporting SpecialistMaximus

Field Support SpecialistTriWest Healthcare Alliance

Provider Data SpecialistTriWest Healthcare Alliance

Pharmacy Government Stars SpecialistIntermountain Health

Risk Adjustment Coding SpecialistLumen Solutions Group Inc

Patient Accounts Specialist I - Medicaid TeamMedStar Health

Medicaid Audit and Compliance Specialist UPIC NE (Full-time, Remote)Integrity Management Services, Inc.

Medicaid Audit and Compliance Specialist UPIC SE (Full-time, Remote)Integrity Management Services, Inc.

Fraud Specialist (hybrid Maryland based)Educational Systems Federal Credit Union

HR Specialist IIOBAN Corporation

Trust Services Account SpecialistAir Line Pilots Association, Int'l.

Credentialing SpecialistLittle Leaves

Sr. QNXT Configuration SpecialistCognizant

Security Officer Patrol Reporting SpecialistAllied Universal

Security Guard - Unarmed Driver Patrol Specialist Full TimeAllied Universal

Clinical Denial Appeals SpecialistAnne Arundel Medical Center

Customer Care Specialist - WFHSpade Recruiting

LEAD EVENT SPECIALIST PART TIMEProduct Connections

Community Account SpecialistGates, Hudson & Associates

Paralegal SpecialistWest 4th Strategy

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