Entry Level Complex Claims Specialist Jobs
New grad complex claims specialist jobs welcome recent graduates and entry level candidates with zero to two years of experience, where a strong internship background or hands-on coursework in insurance or risk can matter more than a long resume. Most openings are on-site roles across Healthcare & Medical Services, Education, and Manufacturing, with employers like Mass General Brigham, Saint Luke's, and Banner Health hiring at this level now.
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Showing 5 of 33+ Entry Level Complex Claims Specialist jobs
Department Name:
Coding-Acute Care Hospital
Work Shift:
Day
Job Category:
Revenue Cycle
Innovation and highly trained staff. Banner Health recently earned Great Place To Work® Certification™. This recognition reflects our investment in workplace excellence and the happiness, satisfaction, wellbeing and fulfilment of our team members. Find out how we’re constantly improving to make Looking for a motivated, experienced Outpatient, Acute Care, HIMS Complex Coder to join our talented Outpatient SDS Complex Facility-coding team. Candidate should have complex coding experience in acute care, all service lines including, but not limited to: General, Orthopedic, Urology/Gynecology, Cardiac, Spinal, etc.
Requirements:
- 2 years recent experience in Outpatient Facility-based coding of Same Day Surgery & Observation (clearly reflected in your attached resume);
- Experienced in ICD-10-PCS & ICD-10-CM coding; as well as CPT
- Must be currently certified through AAPC or Ahima, as defined in minimum qualifications below. (Please upload a copy or provide certification number in your questionnaire.) Please note, this is a COMPLEX role, requiring more than CPC-A level experience.
- A Coding Assessment will be given after a successful interview to be completed within 48 hours. Banner Health provides your equipment when hired. You will be fully supported in during initial training by both the Banner Coding Education team and your hiring manager, with continued support throughout your career here!
Don't quite meet the above requirements? Check out some of our other Coder positions!
The hours are flexible with the ability to work your 8-hour shift between 5am-7pm (Monday-Friday).
This is a fully remote position and available if you live in the following states only: AK, AR, AZ, CA, CO, FL, GA, IA, ID, IN, KS, KY, MI, MN, MO, MS, NC, ND, NE, NM, NV, NY, OH, OK, OR, PA, SC, TN, TX, UT, VA, WA, WI & WY.
Banner Health the best place to work and receive care.
Within Banner Health Corporate, you will have the opportunity to apply your unique experience and expertise in support of a nationally-recognized healthcare leader. We offer stimulating and rewarding careers in a wide array of disciplines. Whether your background is in Human Resources, Finance, Information Technology, Legal, Managed Care Programs or Public Relations, you'll find many options for contributing to our award-winning patient care.
Position Summary
This position provides coding and abstracting for a full range of outpatient complex surgical and observation acute care services at all Banner hospitals. This includes highest level of complexity of accounts encountered in Banner’s Academic, Trauma and high acuity facilities. Reviews health record documentation and assigns diagnoses and/or surgical procedure codes on all outpatient complex records using ICD CM/PCS and CPT4 coding classification systems. Completes APC assignment on outpatient complex records as appropriate. Ensures ethical and accurate coding in accordance with all regulatory requirements and nationally recognized coding guidelines.
CORE FUNCTIONS
-
Analyzes medical information from medical records. Accurately codes diagnostic and procedural information, including modifiers, in accordance with national coding guidelines and appropriate reimbursement requirements. Consults with medical providers to clarify missing or inadequate record information and to determine appropriate diagnostic and procedure codes. Provides thorough, timely and accurate coding in accordance to department specific productivity and quality standards. Codes ICD CM/PCS and CPT4 for accurate APC assignment. Addresses National Correct Coding Initiative (NCCI) edits as appropriate. Reconciliation of charges as required.
-
Abstracts clinical diagnoses, procedure codes and other pertinent information obtained from the patient encounter. Place account in the appropriate status for required missing documentation to complete assignment of disease and procedure codes, and any pertinent abstract elements.
-
Provides quality coding by ensuring compliance with coding rules and regulations according to regulatory agencies for state Medicaid plans, Center for Medicare Services (CMS), Office of the Inspector General (OIG) and the Health Care Financing Administration (HCFA), as well as Banner specific policy and procedures and applicable professional standards for a full range of outpatient complex surgical and observation acute care services at all Banner hospitals. This includes highest level of complexity of accounts encountered in Banner’s Academic, Trauma and high acuity facilities.
-
May provide mentoring for less experienced staff members. May act as a subject matter expert for complex coding.
-
Works under general supervision using specialized expertise in the subject matter. Works within a set of defined rules. Ability to address complex coding matters independently with regard to interpretation of coding guidelines, NCCI edits, and LCDs (Local Coverage Determinations) prior to referral to coding analyst, coding educator, or coding manager/supervisor.
MINIMUM QUALIFICATIONS
High school diploma/GED or equivalent working knowledge and specialized formal training in medical record keeping principles and practices, anatomy, physiology, pathology, medical terminology, standard nomenclature, and classification of diagnoses and operations, or an Associate’s degree in a health care field.
Requires Certified Coding Specialist (CCS) or Certified Outpatient Coder (COC) or Certified Professional Coder (CPC) or Registered Health Information Technologist (RHIT) or Registered Health Information Administration (RHIA) or other appropriate coding certification in an active status with the American Health Information Management Association (AHIMA) or American Academy of Professional Coders (AAPC).
Requires two or more years of outpatient complex experience in an acute care inpatient facility or healthcare system.
Must demonstrate a level of knowledge and understanding of ICD CM/PCS, CPT4 coding principles and coding competencies as demonstrated by certification through the American Health Information Management Association or by the American Academy of Professional Coders.
Must be able to work effectively and efficiently in a remote setting, utilizing common office programs, coding software and abstracting systems.
PREFERRED QUALIFICATIONS
Associates degree in a job-related field or experience equivalent to same.
Previous experience in large, multi-system healthcare organization.
Additional related education and/or experience preferred.
Estimated Pay Range:
$27.35 - $41.03 / hour
Banner Health is committed to pay equity and transparency. The posted compensation range is a reasonable estimate that extends from the lowest to the highest pay Banner Health in good faith believes it might pay for this particular job, based on the circumstances at the time of posting. This range is based on possible base salaries and does not include the value of our total rewards package. Actual pay determined at offer will be based on years of relevant work experience, education, certifications, skills, and geographic location, along with a review of current employees in similar roles to ensure pay equity is achieved and maintained.
Anticipated Closing Window (actual close date may be sooner):
2027-03-10
EEO Statement:
EEO/Disabled/Veterans
Our organization supports a drug-free work environment.
Privacy Policy:
Privacy Policy
Department Name:
Coding-Acute Care Hospital
Work Shift:
Day
Job Category:
Revenue Cycle
Innovation and highly trained staff. Banner Health recently earned Great Place To Work® Certification™. This recognition reflects our investment in workplace excellence and the happiness, satisfaction, wellbeing and fulfilment of our team members. Find out how we’re constantly improving to make Looking for a motivated, experienced Outpatient, Acute Care, HIMS Complex Coder to join our talented Outpatient SDS Complex Facility-coding team. Candidate should have complex coding experience in acute care, all service lines including, but not limited to: General, Orthopedic, Urology/Gynecology, Cardiac, Spinal, etc.
Requirements:
- 2 years recent experience in Outpatient Facility-based coding of Same Day Surgery & Observation (clearly reflected in your attached resume);
- Experienced in ICD-10-PCS & ICD-10-CM coding; as well as CPT
- Must be currently certified through AAPC or Ahima, as defined in minimum qualifications below. (Please upload a copy or provide certification number in your questionnaire.) Please note, this is a COMPLEX role, requiring more than CPC-A level experience.
- A Coding Assessment will be given after a successful interview to be completed within 48 hours. Banner Health provides your equipment when hired. You will be fully supported in during initial training by both the Banner Coding Education team and your hiring manager, with continued support throughout your career here!
Don't quite meet the above requirements? Check out some of our other Coder positions!
The hours are flexible with the ability to work your 8-hour shift between 5am-7pm (Monday-Friday).
This is a fully remote position and available if you live in the following states only: AK, AR, AZ, CA, CO, FL, GA, IA, ID, IN, KS, KY, MI, MN, MO, MS, NC, ND, NE, NM, NV, NY, OH, OK, OR, PA, SC, TN, TX, UT, VA, WA, WI & WY.
Banner Health the best place to work and receive care.
Within Banner Health Corporate, you will have the opportunity to apply your unique experience and expertise in support of a nationally-recognized healthcare leader. We offer stimulating and rewarding careers in a wide array of disciplines. Whether your background is in Human Resources, Finance, Information Technology, Legal, Managed Care Programs or Public Relations, you'll find many options for contributing to our award-winning patient care.
Position Summary
This position provides coding and abstracting for a full range of outpatient complex surgical and observation acute care services at all Banner hospitals. This includes highest level of complexity of accounts encountered in Banner’s Academic, Trauma and high acuity facilities. Reviews health record documentation and assigns diagnoses and/or surgical procedure codes on all outpatient complex records using ICD CM/PCS and CPT4 coding classification systems. Completes APC assignment on outpatient complex records as appropriate. Ensures ethical and accurate coding in accordance with all regulatory requirements and nationally recognized coding guidelines.
CORE FUNCTIONS
-
Analyzes medical information from medical records. Accurately codes diagnostic and procedural information, including modifiers, in accordance with national coding guidelines and appropriate reimbursement requirements. Consults with medical providers to clarify missing or inadequate record information and to determine appropriate diagnostic and procedure codes. Provides thorough, timely and accurate coding in accordance to department specific productivity and quality standards. Codes ICD CM/PCS and CPT4 for accurate APC assignment. Addresses National Correct Coding Initiative (NCCI) edits as appropriate. Reconciliation of charges as required.
-
Abstracts clinical diagnoses, procedure codes and other pertinent information obtained from the patient encounter. Place account in the appropriate status for required missing documentation to complete assignment of disease and procedure codes, and any pertinent abstract elements.
-
Provides quality coding by ensuring compliance with coding rules and regulations according to regulatory agencies for state Medicaid plans, Center for Medicare Services (CMS), Office of the Inspector General (OIG) and the Health Care Financing Administration (HCFA), as well as Banner specific policy and procedures and applicable professional standards for a full range of outpatient complex surgical and observation acute care services at all Banner hospitals. This includes highest level of complexity of accounts encountered in Banner’s Academic, Trauma and high acuity facilities.
-
May provide mentoring for less experienced staff members. May act as a subject matter expert for complex coding.
-
Works under general supervision using specialized expertise in the subject matter. Works within a set of defined rules. Ability to address complex coding matters independently with regard to interpretation of coding guidelines, NCCI edits, and LCDs (Local Coverage Determinations) prior to referral to coding analyst, coding educator, or coding manager/supervisor.
MINIMUM QUALIFICATIONS
High school diploma/GED or equivalent working knowledge and specialized formal training in medical record keeping principles and practices, anatomy, physiology, pathology, medical terminology, standard nomenclature, and classification of diagnoses and operations, or an Associate’s degree in a health care field.
Requires Certified Coding Specialist (CCS) or Certified Outpatient Coder (COC) or Certified Professional Coder (CPC) or Registered Health Information Technologist (RHIT) or Registered Health Information Administration (RHIA) or other appropriate coding certification in an active status with the American Health Information Management Association (AHIMA) or American Academy of Professional Coders (AAPC).
Requires two or more years of outpatient complex experience in an acute care inpatient facility or healthcare system.
Must demonstrate a level of knowledge and understanding of ICD CM/PCS, CPT4 coding principles and coding competencies as demonstrated by certification through the American Health Information Management Association or by the American Academy of Professional Coders.
Must be able to work effectively and efficiently in a remote setting, utilizing common office programs, coding software and abstracting systems.
PREFERRED QUALIFICATIONS
Associates degree in a job-related field or experience equivalent to same.
Previous experience in large, multi-system healthcare organization.
Additional related education and/or experience preferred.
Estimated Pay Range:
$27.35 - $41.03 / hour
Banner Health is committed to pay equity and transparency. The posted compensation range is a reasonable estimate that extends from the lowest to the highest pay Banner Health in good faith believes it might pay for this particular job, based on the circumstances at the time of posting. This range is based on possible base salaries and does not include the value of our total rewards package. Actual pay determined at offer will be based on years of relevant work experience, education, certifications, skills, and geographic location, along with a review of current employees in similar roles to ensure pay equity is achieved and maintained.
Anticipated Closing Window (actual close date may be sooner):
2027-03-10
EEO Statement:
EEO/Disabled/Veterans
Our organization supports a drug-free work environment.
Privacy Policy:
Privacy Policy
See All 33 Entry Level Complex Claims Specialist Jobs
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Find JobsEntry Level Complex Claims Specialist Job Market
Who's Hiring
Top Industries Hiring
- Healthcare & Medical Services26
- Education3
- Manufacturing2
- Law & Legal Services1
Entry Level Complex Claims Specialist Jobs: Frequently Asked Questions
How do I get an entry level complex claims specialist job?
Start by building familiarity with claims workflows, coverage interpretation, and documentation standards through coursework, internships, or volunteer work in insurance or legal settings. Employers at this level look for strong written communication, attention to detail, and the ability to gather and organize case information. An associate or bachelor's degree in business, risk management, or a related field gives candidates a clear edge when applying.
Which companies hire entry level complex claims specialists?
Companies hiring entry level complex claims specialists right now include Mass General Brigham, Saint Luke's, and Banner Health, based on current listings on Migrate Mate as of November 2026. Hiring at this level comes from a mix of national insurance carriers, regional specialty insurers, and third-party claims administrators who regularly bring on junior talent and train them on proprietary systems.
Are there remote entry level complex claims specialist jobs?
Yes, though most entry level roles still favor on-site or hybrid arrangements. About 41% of entry level complex claims specialist openings are remote or hybrid as of November 2026, reflecting employer preference for in-person training and mentorship during the early stages of the role before candidates work more independently.
Are these new grad complex claims specialist jobs?
Yes, many of these postings are new grad and junior roles that welcome recent graduates and candidates with little to no prior experience. A new grad-friendly posting typically welcomes zero to two years of experience, accepts internships or relevant coursework in lieu of full-time history, and may reference a training program or structured onboarding for candidates building their skills from the ground up.
Which industries hire the most entry level complex claims specialists?
Entry Level complex claims specialist roles concentrate in Healthcare & Medical Services, Education, and Manufacturing, based on current listings on Migrate Mate as of November 2026. These sectors drive hiring at this level because high claim volumes, regulatory complexity, and ongoing caseload growth create consistent demand for junior specialists who can support senior adjusters and examiners.