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Claim Submission Specialist

Role overview

Qualifications

  • High school diploma or GED required
  • 3+ years of experience in medical billing, claims processing, claims submission, Revenue Cycle Management, or related healthcare operations
  • Working knowledge of medical claims, insurance billing workflows, payer requirements, claim edits, and clearinghouse processes
  • Proficiency in Microsoft Office, particularly Excel, Word, and Outlook

Responsibilities

  • Review, correct, and submit medical claims to insurance payers in accordance with payer requirements, billing regulations, and organizational standards
  • Validate patient demographics, insurance coverage, provider information, and claim data to support accurate and timely claim submission
  • Resolve claim edits, clearinghouse rejections, and payer rejections by researching requirements and correcting submission errors
  • Collaborate with internal Revenue Cycle teams and offshore vendors to resolve claim issues, maintain quality standards, and reduce rework

Key facts

Hard skills

Other skills

  • Problem Solving
  • Analytical Skills
  • Organizational Skills
  • Microsoft Office
  • Communication
  • Detail Oriented
  • Research

About the company

ARA Diagnostic Imaging - Austin Radiological Association logo

ARA Diagnostic Imaging - Austin Radiological Association

  • 501–1,000
Austin Radiological Association - ARA Diagnostic Imaging is Austin’s oldest leading diagnostic imaging group. We offer expert medical imaging by radiologists subspecialized in MRI, CT, ultrasound, interventional, mammography, and more. Our roots go back to 1954, when Dr. Robert Snider began work as the first full-time radiologist at the original Seton Hospital. Today, the leaders and staff of ARA work in partnership with doctors to bring better health outcomes for our patients. Thoughtful leadership, advanced technology and attention to patient comfort and convenience sets us apart as a successful, caring imaging facility. •Constant technology upgrades bring the best to physician and patients. 3D mammography is now available at all 12 of our locations that offer breast imaging. •Convenience and accessibility for our patients is paramount. We operate 17 outpatient imaging centers and provide radiology reading services to 21 area hospitals throughout Austin and Central Texas. •Strong relationships with insurance and managed care payors allow access to quality imaging services for our patients.•Our team of radiologists has the broadest array of subspecialty in Central Texas. Award-winning PACS services to view digital images and 24/7 physician access to ARA radiologists make ARA an ideal physician partner•ARA is strongly focused on patient outcomes as well as patient experience. Our 94 percent patient satisfaction rate reflects our commitment to caring service.With 750+ employees and 110+ radiologists, ARA’s commitment to ensure access to high quality imaging technologies while delivering excellent patient satisfaction to our community has never been stronger. ARA is proud to have been selected as a Top Austin Workplace three years in row: 2015, 2016 & 2017! If you are seeking a career in the medical field as a radiologist, technologist or customer service representative, we encourage you to apply: https://www.ausrad.com/careers-austin-job-seekers/

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Job description

WHO WE ARE AND WHAT WE DO:
Radiology Partners, through its affiliated practices, is a leading radiology practice in the U.S., serving hospitals and other healthcare facilities across the nation. As a physician-led and physician-owned practice, our mission is to transform radiology by innovating across clinical value, technology, service, and economics, while elevating the role of radiology and radiologists in healthcare. Using a proven healthcare services model, Radiology Partners provides consistent, high-quality care to patients, while delivering enhanced value to the hospitals, clinics, imaging centers and referring physicians we serve.

POSITION SUMMARY:

  • Review, correct, and submit medical claims to insurance payers in accordance with payer requirements, billing regulations, and organizational standards.
  • Validate patient demographics, insurance coverage, provider information, and claim data to support accurate and timely claim submission.
  • Resolve claim edits, clearinghouse rejections, and payer rejections by researching requirements and correcting submission errors.
  • Collaborate with internal Revenue Cycle teams and offshore vendors to resolve claim issues, maintain quality standards, and reduce rework.
  • Identify recurring claim issues, support root-cause analysis, and contribute to process improvements that improve clean claim rates and reimbursement outcomes.

DESIRED PROFESSIONAL SKILLS AND EXPERIENCE:

  • High school diploma or GED required, with 3+ years of experience in medical billing, claims processing, claims submission, Revenue Cycle Management, or related healthcare operations.
  • Working knowledge of medical claims, insurance billing workflows, payer requirements, claim edits, and clearinghouse (PHIcure) processes.
  • Experience with Medicare, Medicaid, Medicare Advantage, and commercial insurance billing requirements.
  • Proficiency in Microsoft Office, particularly Excel, Word, and Outlook, and experience with healthcare billing or practice management systems.
  • Strong analytical, research, problem-solving, organizational, and communication skills, with attention to detail and the ability to manage high-volume workloads; experience with Imagine, Availity, or similar systems preferred.

WHY RADIOLOGY PARTNERS:

  • Competitive Benefits package - Eligibility starts the month after hire, with tiered options to choose from.
  • Compensation Reviews, Career Growth Opportunities
  • Flexible Remote Schedules
  • Generous PTO Plans and Paid Holidays
  • Proudly Certified as a Great Place to Work for Five Consecutive Years

FOR MORE INFORMATION:

Demographic SpecialistClaim Submisson Specialist JobDEMSPECOctober 2026

COMPENSATION:
The pay range for this position is $18.00-$20.00 / hr. Final determinations may vary based on several factors including but not limited to education, work experience, certifications, geographic location, etc. This role is also eligible for an annual discretionary bonus. In addition to this range, Radiology Partners offers competitive total rewards packages, which include health & wellness coverage options, 401(k) benefits, and a broad range of other benefits such as family planning and telehealth (all benefits are subject to eligibility requirements).

Radiology Partners is an equal opportunity employer. RP is committed to being an inclusive, safe and welcoming environment where everyone has equal access and equitable resources to reach their full potential. We are united by our Mission to Transform Radiology and in turn have an important impact on the patients we serve and the healthcare system overall. Diversity is a key source of strength, and we strive to foster a culture that is inclusive for all.

CCPA Notice:
When you submit a job application or resume, you are providing the Practice with the following categories of personal information that the Practice will use for the purpose of evaluating your candidacy for employment: (1) Personal Identifiers; and (2) Education and Employment History.

Radiology Partners participates in E-Verify.

Beware of Fraudulent Messages:
Radiology Partners will never request payment, banking, or other financial information in exchange for interviews or as part of the hiring process. Additionally, we will not send checks for deposit into your bank account at any stage of recruitment. All communication during the interview and hiring process should come from an email address ending in "@radpartners.com." If you suspect you are receiving a fraudulent job offer or solicitation from Radiology Partners or one of our local practices, please email Talent@radpartners.com to notify our team.

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