Remote Insurance Claims Resolution Specialist

Digitech; United States; On-site; USD 42,000 - 66,000; Full time

Benefits offered by this job

401(k) Plan

Job summary

Digitech is seeking a highly motivated Insurance Account Resolution Specialist to manage and resolve insurance claims after submission to Medicare HMOs, Medicaid MCOs, and Facilities. This remote, work-from-home role requires accuracy, analytical skills, and the ability to handle a high-volume workload.

The position operates Monday through Friday during standard business hours, aligned with Eastern Time, and offers a comprehensive benefits package and competitive compensation.

Qualifications

• Education: High School Diploma or equivalent required.
• Strong computer skills including MS Outlook, Word, Excel.
• Ability to type 40 WPM with accuracy.
• Proven ability to handle high-volume workloads and meet deadlines.
• Experience in a structured environment with call monitoring or productivity metrics is helpful.
• Strong verbal and written communication for documentation and correspondence.
• Highly organized and able to work independently in a remote environment.

Responsibilities

• Research and resolve outstanding insurance claims from Medicare HMOs, Medicaid MCOs, and facilities.
• Investigate claims on hold, identify root causes, correct errors and follow up to release.
• Analyze denials, determine reasons, and pursue resolutions such as appeals or resubmissions.
• Communicate with insurance carriers to obtain status and clarify discrepancies.
• Prepare and submit documentation requested by carriers to support adjudication.
• Draft and submit appeals with proper documentation and guidelines.
• Process incoming correspondence and refunds as needed.
• Maintain detailed notes in billing systems for follow-up actions.
• Identify trends and escalate to improve processes.
• Meet daily productivity and accuracy targets.

Skills

Communication

Time management

Attention to detail

Remote work capable

Typing 40 WPM

Education

High School Diploma or equivalent

Tools

MS Outlook

MS Word

MS Excel

Job description

Digitech is seeking a highly motivated Insurance Account Resolution Specialist to manage and resolve insurance claims after submission to Medicare HMOs, Medicaid MCOs, and Facilities. This remote, work-from-home role requires accuracy, analytical skills, and the ability to handle a high-volume workload.

The position operates Monday through Friday during standard business hours, aligned with Eastern Time, and offers a comprehensive benefits package and competitive compensation.