Claims Medicare Compliance Specialist

Compre Group; United States; Teletrabalho; USD 80 000 - 100 000; Tempo integral

Vantagens oferecidas por esta oferta de emprego

Competitive salary and bonus eligible

Medical, EAP, dental & vision

HSA plan with Compre funding Life Ins

401k with Company Match

Company Off-Site Meetings

Remote Worker Expenses

Health and Wellbeing Programs

Employee Referral Program

Personal Development

Generous vacation and holiday schedule

Resumo da oferta

Compre Group is seeking a Claims Medicare Compliance Specialist to support Medicare reporting and compliance for North America, with remote East Coast flexibility. The role reports to the Claims Compliance and Quality leadership and focuses on maintaining claim data, Medicare query resolution, and CMS submission readiness.

Ideal candidates will bring Medicare knowledge, strong Excel skills, and the ability to manage priorities in a regulated environment.

Qualificações

• This is an excellent development opportunity to build Medicare insurance claims skills.
• You’ll need strong Excel skills, attention to detail and the ability to manage priorities in a regulated environment.
• Having some Medicare experience or knowledge is essential; training toward Medicare accreditation will be provided.

Responsabilidades

• Maintain accurate claim data and run Medicare queries.
• Prepare records for CMS submissions and investigate reporting exceptions.
• Collaborate with claims teams, TPAs, and vendors to resolve issues.
• Support data-quality reviews, remediation projects and reporting deadlines.

Conhecimentos

Medicare knowledge

Data validation

Regulatory compliance

Prioritization

Attention to detail

Ferramentas

Excel

CMS submissions tools

Descrição da oferta de emprego

Claims Medicare Compliance Specialist

Department: Claims

Employment Type: Full Time

Location: USA (New Hampshire / Remote)

Description

Claims Medicare Compliance Specialist

North America Remote

remote East Coast

full-time

We are a fast-growing global reinsurance speciality company servicing the insurance markets of Lloyd’s, Europe and North America.

Due to growth, we’re now looking for our first dedicated Medicare specialist to support Medicare reporting and compliance activity.

Key Responsibilities

Reporting to the Claims Compliance and Quality AVP, you’ll help maintain accurate claim data, run and review Medicare queries, prepare records for CMS submissions, investigate reporting exceptions and work with claims teams, TPAs and vendors to resolve issues. You’ll also support data-quality reviews, remediation projects and reporting deadlines.

Candidate requirements

This is an excellent development opportunity for someone to develop their Medicare insurance claims skills, ideally coming from operational support, data validation or compliance. You’ll need strong Excel skills, attention to detail and the ability to manage priorities in a regulated environment.

Having some Medicare experience or knowledge is essential. We’ll support you to build your knowledge and complete a relevant Medicare accreditation or qualification as part of your development in the role.

Benefits

Fulfil your potential in a collaborative environment with some of the best talent in the industry, while enjoying:

• Flex First
  • Empowering employees to thrive in any location. Our innovative Flex First approach enables employees to perform to their full potential, regardless of their location, while fostering a sense of community through regular events and collaboration.
• Benefits
  • Competitive salary and bonus eligible
  • Medical, EAP, dental, & vision insurance for individuals and families
  • Excellent HSA plan with Compre funding Life Insurance
  • 401k with Company Match
  • Company Off-Site Meetings
  • Remote Worker Expenses
  • Health and Wellbeing Programs
  • Employee Referral Program
• Personal Development
  • Advancing your professional development through ongoing learning opportunities.
• Time Off
  • Generous vacation and holiday schedule STD & LTD coverage