Medicare Account Resolution Specialist

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

📋 Description

• Process Medicare claims that are pending, unable to be released, denied, or inaccurately paid, ensuring each claim is properly resolved and reinstated to payment status.

• Evaluate and resolve claims that are on hold by identifying the cause of the hold, rectifying errors, and executing all necessary follow-up actions.

• Assess Medicare denials to verify their accuracy, determine subsequent steps, and complete appeals, adjustments, or resubmissions as required.

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

• Prepare, manage, and monitor correspondence including letters, emails, supporting documents, and required refunds.

• Maintain comprehensive and precise notes, documentation, and workflow updates within billing systems to facilitate claim progression and meet audit requirements.

• Undertake additional job responsibilities as assigned.

⛳️ Requirements

• High School Diploma or equivalent is mandatory.

• Proficient in computer skills, with a working knowledge of MS Outlook, Word, and Excel.

• Capable of typing 40 WPM with accuracy.

• Demonstrated ability to manage high-volume workloads, prioritize tasks effectively, and meet stringent deadlines.

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

• Ability to maintain composure, professionalism, and effectiveness during phone interactions while upholding a positive company image.

• Exceptional written and verbal communication abilities, with the capacity to convey information clearly and professionally.

• High attention to detail with strong accuracy in claim assessment and documentation.

• Excellent organizational and time management skills, with the capability to prioritize tasks and complete assigned work efficiently.

• Ability to independently manage all facets of the job role, including required objectives and business practices in a remote setting.

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

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

• Capability to secure confidential information.

• Perform all duties in a professional environment devoid of noise or any factors that could negatively impact customer experience.

🏝️ Benefits

• Competitive salary, based on experience.

• Comprehensive benefits package.

• 401(k) Plan.

• Remote work arrangement.