Medicare Account Resolution Specialist - Digitech - Remote

Sarnova; Oregon; Híbrido; USD 30.000 - 39.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

401(k) Plan

Descripción de la vacante

Sarnova is seeking a Medicare Account Resolution Specialist to manage Medicare claims post-submission, ensuring accurate and timely processing. You will navigate denials, follow-up, and adherence to Medicare guidelines in a remote work setting.

The ideal candidate demonstrates strong analytics, meticulous attention to detail, and the ability to handle multiple tasks in a fast-paced billing environment while maintaining a professional tone and accurate documentation.

Formación

• High School Diploma or equivalent required.
• Strong computer skills with MS Outlook, Word and Excel.
• Type a minimum of 40 WPM with accuracy.
• Proven ability to manage high-volume workloads with deadlines.
• Experience in an environment with call monitoring or productivity metrics preferred.
• Excellent written and verbal communication skills.
• High attention to detail with accurate documentation.
• Ability to work remotely in a professional manner.

Responsabilidades

• Manage Medicare claims pending, denied, or paid incorrectly to return to payment status.
• Review holds, identify causes, correct errors and complete follow-up actions.
• Analyze denials to determine accuracy and complete appeals or resubmissions.
• Provide additional documentation to Medicare for accurate adjudication.
• Prepare and track letters, emails, and refunds.
• Maintain detailed notes and workflow updates in billing systems.
• Perform additional duties as assigned.

Conocimientos

MS Outlook

MS Word

MS Excel

Typing 40 WPM

High volume work

Call monitoring

Communication skills

Remote environment

Educación

High School Diploma or equivalent

Descripción del empleo

The Sarnova Family of companies includes Digitech Computer, Bound Tree Medical, Tri-anim Health Services and Cardio Partners. 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 with working knowledge of MS Outlook, Word, and Excel
• Ability to type a minimum of 40 WPM with accuracy
• Proven ability to manage high‑volume workloads while meeting strict 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. Work Schedule : Employee will be required to work forty (40) hours of per week as defined by their schedule.

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.

Benefits

• 401(k) Plan

Last Reviewed Date: 3/9/2026

Last Reviewed By: Haley Bowman, Medicare Manager