Medicare Claims Specialist

Job Summary

To support accurate claims processing, the full-time temporary Claims Specialist will manage complex Medicare claims remotely, ensuring compliance and efficiency while collaborating with various stakeholders.

Key responsibilities

• Process, adjust, and update moderate to complex claims payments and resolve payment errors
• Review Medicare Advantage and Supplement claims, including DTPs and Facets processing
• Investigate and resolve suspended claims using eligibility, claims history, and related data

Required qualifications

• High school diploma or GED
• 3+ years of experience in claims processing or a related field
• Strong experience with Medicare Advantage and Medicare Supplement claims
• Familiarity with Facets and claims processing systems
• Ability to manage production goals in a fast-paced environment