Medicare Account Resolution Specialist

This is a fully remote position, open to applicants in United States.

📋 Description

• Oversee and resolve Medicare claims post-submission to guarantee accurate and timely processing.

• Address pending, unreleased, denied, or improperly paid Medicare claims and restore them to payment status.

• Review and resolve claims that are on hold by identifying issues, correcting mistakes, and executing follow-up actions.

• Analyze Medicare denials and execute appeals, adjustments, or resubmissions as necessary.

• Supply Medicare with any additional documentation or information needed for claim adjudication.

• Prepare, process, and monitor letters, emails, supporting documents, and required refunds.

• Maintain thorough notes, documentation, and workflow updates in billing systems for claim tracking and audit necessities.

• Perform other duties as assigned.

⛳️ Requirements

• A High School Diploma or equivalent is required.

• Strong computer proficiency with a working knowledge of MS Outlook, Word, and Excel.

• Ability to type a minimum of 40 WPM with precision.

• Demonstrated ability to manage high-volume workloads while adhering to strict deadlines.

• Experience in a setting with call monitoring, productivity metrics, or performance scoring is preferred.

• Capability to remain calm, professional, and effective during phone interactions while upholding a positive company image.

• Excellent written and verbal communication skills, with the ability to convey information clearly and professionally.

• High attention to detail with a strong focus on accuracy in claim review and documentation.

• Strong organizational and time-management skills with the ability to prioritize tasks and complete assignments efficiently.

• Ability to independently manage all facets of the job role, including meeting goals and adhering to business practices in a remote environment.

• Ability to talk, hear, and see clearly to read and interpret information.

• Regular use of a computer, phone, and standard office equipment.

• Ability to secure confidential information.

• Must be available to work 40 hours per week according to the designated schedule.

🏝️ Benefits

• Competitive salary, based on experience.

• Comprehensive benefits package.

• 401(k) Plan.

• Remote work environment.