Medicare Account Resolution Specialist - Digitech - Remote

Summary

The Medicare Account Resolution Specialist is responsible for managing and resolving Medicare claims after submission to ensure accurate and timely processing.

Essential Duties And Responsibilities

• Work Medicare claims that are pending, unable to be released, denied, or paid incorrectly, ensuring each claim is resolved appropriately and returned to payment status
• Review and resolve claims placed on hold by identifying the reason for the hold, correcting errors, and completing all required follow up actions
• Analyze Medicare denials to determine accuracy, identify next steps, and complete appeals, adjustments, or resubmissions as needed
• Provide Medicare with any additional documentation or information necessary for accurate claim adjudication
• Prepare, process, and track correspondence such as letters, emails, supporting documents, and required refunds
• Maintain detailed and accurate notes, documentation, and workflow updates within billing systems to support claim progression and audit requirements

Skills/Experience Required

• Education: High School Diploma or equivalent required
• Strong computer skills, including working knowledge of MS Outlook, Word, and Excel
• Ability to type 40 WPM with accuracy
• Proven ability to handle high-volume workloads, prioritize effectively, and meet tight deadlines
• Experience in an environment with call monitoring, productivity metrics, or performance scoring is preferred
• Ability to remain calm, professional, and effective during phone interactions while maintaining a positive company image
• Excellent written and verbal communication skills, with the ability to explain information clearly and professionally
• High attention to detail with strong accuracy in claim review and documentation
• Strong organizational and time management skills with the ability to prioritize work and complete assigned tasks efficiently
• Ability to independently manage all aspects of the job role including required goals and business practices in a remote environment

Physical Requirements

• 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
• Perform all duties in a professional environment free of noise or anything that would create a negative customer experience

Sarnova is an Equal Opportunity Employer

We offer a competitive salary, commensurate with experience, along with a comprehensive benefits package, including 401(k) Plan. EO/M/F/Veterans/Disabled. Our mission is to be the best partner for those who save and improve patients’ lives. Excellence in delivering upon our mission is dependent upon having a diverse team that is empowered to bring their full, authentic self to work each day. We strive to create a workplace that reflects the communities we serve, and we are passionate about creating an inclusive workplace that promotes and values diversity. #digitech