Medicare Account Resolution Specialist - Digitech - Remote

Tri-anim Health Services, Inc.; Northern (KY); Hybrid; USD 42,000 - 60,000; Full time

Benefits offered by this job

401(k) Plan

Job summary

Digitech is seeking a Medicare Account Resolution Specialist to manage and resolve Medicare claims after submission, ensuring timely processing. The ideal candidate has strong analytical skills, attention to detail, and can handle multiple tasks in a fast-paced billing environment.

The role requires navigating Medicare guidelines, denials, and follow‑up processes, with duties including reviewing holds, preparing appeals, and maintaining audits and documentation.

Qualifications

• High School Diploma or equivalent required.
• Proficiency with MS Outlook, Word and Excel.
• Ability to type 40 WPM with accuracy.
• Experience handling high‑volume workloads and meeting deadlines.
• Strong written and verbal communication skills.

Responsibilities

• Manage Medicare claims pending, denied, or mispaid to restore payment status.
• Review holds, identify reasons, correct errors, and complete follow up.
• Analyze denials and determine next steps, appeals, adjustments, or resubmissions.
• Provide required documentation to Medicare for accurate adjudication.
• Process and track correspondence and refunds with detailed notes.
• Maintain auditing-ready documentation in billing systems.
• Perform additional duties as assigned.

Skills

MS Outlook

MS Word

Excel

Type 40 WPM

Remote work capability

High-volume workload

Attention to detail

Strong communication

Education

High School Diploma

Job description

The Sarnova Family of companies includes Digitech Computer, Bound Tree Medical, Tri-anim Health Services, Cardio Partners, and Emergency Medical Products
Digitech is a leading provider of advanced billing and technology services to the EMS transport industry. Since its founding in 1984, Digitech has refined its software platform to create a cloud-based billing and business intelligence solution that monitors and automates the entire EMS revenue lifecycle. Digitech leverages its proprietary technology to offer fully outsourced services that maximize collections, protect compliance, and deliver results for clients.

Summary:

The Medicare Account Resolution Specialist is responsible for managing and resolving Medicare claims after submission to ensure accurate and timely processing. This role requires strong analytical skills, exceptional attention to detail, and the ability to manage multiple tasks in a fast-paced billing environment. The ideal candidate is thorough, dependable, and skilled at navigating Medicare guidelines, denials, and follow-up processes.

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
• Additional job duties as assigned

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

Work environment characteristics described here are representative of those that must be met by an employee to successfully perform the essential function of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

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.

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