Position Overview
The Healthcare Claims Specialist ensures accurate claim creation and submission to insurance carriers, playing a vital role in our revenue cycle management. This position requires meticulous attention to detail, strong knowledge of billing compliance, and the ability to work independently in a remote environment to maximize reimbursement and minimize claim denials.
Remote Work Requirements : Candidates must maintain a dedicated workspace with minimal distractions and reliable high-speed internet (minimum 25 Mbps download / 10 Mbps upload).
Key Responsibilities
Claims Processing & Documentation
Verify accuracy of CPT, ICD-10, and HCPCS codes against services rendered
Apply payer-specific billing guidelines and internal compliance rules to all claims
Validate patient demographics, insurance eligibility, authorizations, and referrals before submission Quality Assurance & Problem Resolution
Identify and flag incomplete or inconsistent documentation for provider or coder review
Collaborate with coding and billing teams to resolve issues that impact claim processing
Meet or exceed established productivity and accuracy performance metrics
Maintain strict adherence to HIPAA regulations and organizational privacy standards Additional Duties
Support other revenue cycle activities as assigned by supervisor
Stay current on payer rule changes and coding updates
Required Qualifications
Education & Experience
High school diploma or equivalent required
Minimum 2 years of experience in healthcare billing, claims processing, or related administrative role
Working knowledge of medical terminology and insurance billing practices Technical Skills
Proficiency with Microsoft Office Suite
Experience using practice management systems and Electronic Health Records (EHR)
Basic understanding of CPT, ICD-10, and HCPCS coding systems
Familiarity with payer-specific billing edits and requirements Core Competencies
Exceptional attention to detail and organizational abilities
Self-motivated with proven ability to work independently with minimal supervision
Strong analytical and problem-solving capabilities
Clear written and verbal communication skills
Ability to manage competing priorities and meet tight deadlines
Preferred Qualifications
Experience with specialty practice billing (orthopedics, cardiology, etc.)
Medical billing or coding certification (CPC, CPB, CBCS, or similar)
Coursework or training in healthcare administration or revenue cycle management
Previous remote work experience in healthcare setting
Physical Requirements & Work Environment
This position requires :
Extended periods of sitting and computer work
Eye-hand coordination and manual dexterity for operating keyboard, phone, and office equipment
Visual acuity and hearing sufficient for documentation review and team communication
Ability to maintain focus and productivity in a remote work environment
Flexibility to work under deadline pressure and occasionally irregular hours
Vaco by Highspring values a diverse workplace and strongly encourages women, people of color, LGBTQ+ individuals, people with disabilities, members of ethnic minorities, foreign-born residents, and veterans to apply.
EEO Notice
Vaco by Highspring is an Equal Opportunity Employer and does not discriminate against any employee or applicant for employment because of race (including but not limited to traits historically associated with race such as hair texture and hair style), color, sex (includes pregnancy or related conditions), religion or creed, national origin, citizenship, age, disability, status as a veteran, union membership, ethnicity, gender, gender identity, gender expression, sexual orientation, marital status, political affiliation, or any other protected characteristics as required by federal, state or local law.
Vaco by Highspring and its parents, affiliates, and subsidiaries are committed to the full inclusion of all qualified individuals. As part of this commitment, Vaco by Highspring and its parents, affiliates, and subsidiaries will ensure that persons with disabilities are provided reasonable accommodations. If reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and / or to receive other benefits and privileges of employment, please contact HR@vaco.com .
Vaco by Highspring also wants all applicants to know their rights that workplace discrimination is illegal .
By submitting to this position, you agree that you will be giving Vaco by Highspring the exclusive right to present your as a candidate for the foregoing employment opportunity. You further agree that you have represented information about yourself accurately and have not affirmatively misrepresented your qualifications. You also agree to maintain as confidential, to the fullest extent permitted by law, any information you learn from Vaco by Highspring about the position and you will limit disclosure of information about the position only to the extent necessary to perform any obligations in furtherance of your application. In exchange, Vaco by Highspring agrees to exercise reasonable efforts to represent you through all solicitation, job screening and resume dispersal.
Privacy Notice
Vaco by Highspring and its parents, affiliates, and subsidiaries (“we,” “our,” or “Vaco by Highspring”) respects your privacy and are committed to providing transparent notice of our policies.
California residents may access Vaco by Highspring HR Notice at Collection for California Applicants and Employees here .
Pay Transparency Notice
Determining compensation for this role (and others) at Vaco by Highspring depends upon a wide array of factors including but not limited to :
With that said, as required by local law, Vaco by Highspring believes that the following salary range referenced above reasonably estimates the base compensation for an individual hired into this position in geographies that require salary range disclosure. The individual may also be eligible for discretionary bonuses.
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