HMA is the premier third-party health plan administrator across the PNW and beyond. We relentlessly deliver on our promise to provide medium to large-size employers with customized health plans. We offer various high-quality, affordable healthcare plan options supported with best-in-class customer service.
We are proud to say that for three years, HMA has been chosen as a 'Washington's Best Workplaces' by our Staff and PSBJ™. Our vision, 'Proving What's Possible in Healthcare™,' and our values, People First!, Be Extraordinary, Work Courageously, Own It, and Win Together, shape our culture, influence our decisions, and drive our results.
What we are looking for: We are always searching for unique people to add to our team. We only hire people that care deeply about others, thrive in evolving environments, gain satisfaction from being part of a team, are motivated by tackling complex challenges, are courageous enough to share ideas, action-oriented, resilient, and results-driven.
What you can expect: You can expect an inclusive, flexible, and fun culture, comprehensive salary, pay transparency, benefits, and time off package with plenty of personal development and growth opportunities. If you are looking for meaningful work, a clear purpose, high standards, work/life balance, and the ability to contribute to something important, find out more about us at: https://www.accesshma.com/
How YOU will make a Difference:
The Claims Specialist will work with a team responsible for the accurate and timely handling of all claims received, which consist of medical, dental vision and short-term disability that HMA administers for our clients.
What YOU will do:

• SME: Working knowledge of claims process, systems, and associated regulations at the local, state, and federal level
• Post Processing Specific SME expertise: In-depth knowledge of adjustments, stop pay & re-issues, voids, appeals processes, accumulator processing, and refunds
• Business knowledge: Demonstrates operational business and Claims subject matter expertise.
• Troubleshooting: Ability to identify issues, recommend solutions, and manage situation to resolution
• Customer and Provider relationship management: Effectively responds to customer and provider inquiries and focuses on issue resolution
• Trainer/Auditor: Ability to train and effectively audit post processing activities internally and with vendor staff
• Reporting: Ability to summarize issues and solution recommendation to management

Knowledge, Experience, and Key Attributes needed for Success:

• 12+ years of claims processing experience
• High school diploma, Associates Degree or equivalent required
• Strong interpersonal and communication skills
• Impeccable attention to detail, with high degree of accuracy and urgency
• Ability to take initiative and ownership of assigned tasks, working independently with minimal supervision, yet maintain a team-oriented and collaborative approach to problem solving
• Previous success in a fast-paced environment

CompensationThe base salary range for this position in the greater Seattle area is $67,000 - $86,000 for a level IV and varies dependent on geography, skills, experience, education, and other job or market-related factors. While we are looking for level II, we may consider level III for highly qualified candidates. In addition, HMA provides a generous total rewards package for full-time employees that includes: seventeen (IC) days paid time off; eleven paid holidays, one paid personal and one paid volunteer day; company-subsidized medical, dental, vision, and prescription insurance; company-paid disability, life, and AD&D insurances; voluntary life insurances; HSA and FSA pre-tax programs; 401(k)-retirement plan with company match; wellness incentive and reimbursement; remote work and continuing education reimbursements; discount program; parental leave; and a charitable giving match. For more information about HMA, visit www.accesshma.com .
Disclaimer: The salary, other compensation, and benefits information are accurate as of this posting date. HMA reserves the right to modify this information at any time, subject to applicable law.
How we Support your Work, Life, and Wellness Goals
We offer a comprehensive total rewards package including: competitive pay; annual incentive; medical, dental, and vision insurance; 401K retirement plan with match; generous PTO and holidays; an onsite gym facility; a gym subsidy; Life, AD&D, Short-Term and Long-Term Disability Insurances; an Employee Assistance Plan; free parking and easy freeway access to I-405 and I-520; a well-stocked kitchen on-site with subsidized snacks and refreshments; year-round wellness activities; the ability to earn a $500 wellness incentive; monthly events; paid volunteer hours and more!
HMA requires a background screen prior to employment.
Protected Health Information (PHI) Access Healthcare Management Administrators (HMA) employees may encounter protected health information (PHI) in the regular course of their work. All PHI shall be used and disclosed on a need-to-know-basis and according to HMA's standard policies and procedures.
HMA is an Equal Opportunity Employer