Remote Medicaid Claims Resolution Specialist

Sarnova HC, LLC; Dublin (OH); Remote; USD 28,000 - 39,000; Full time

Job summary

Sarnova HC, LLC is seeking a Medicaid Account Resolution Specialist for Digitech with 100% remote work. You will resolve Medicaid claims after submission, ensuring accurate reimbursement and timely follow-up across the billing lifecycle.

The role requires attention to detail, ability to manage multiple priorities, and commitment to high-quality service for clients and patients. Remote work and a fast-paced environment are core aspects of the job.

Qualifications

• High School Diploma or equivalent.
• Strong computer proficiency with MS Outlook, Word, and Excel.
• Ability to multi-task in a fast-paced environment.
• Minimum typing speed of 40 WPM with accuracy.
• Proven ability to manage a high volume of work while meeting strict deadlines.
• Experience in metrics-driven environments (call centers or performance-based roles) is helpful.
• Remain calm and professional during phone interactions while representing the company.
• Excellent written and verbal communication skills; clearly present information and resolve issues.
• High attention to detail with accuracy and follow-through.
• Organize, prioritize, and manage workload independently.
• Ability to independently manage all aspects of the job in a remote environment.

Responsibilities

• Review Medicaid claims pending, on hold, denied, or paid incorrectly and take steps to resolve issues.
• Identify why claims are on hold by reviewing details, correcting errors, ensuring required information is complete and compliant with Medicaid guidelines.
• Evaluate denial reasons, determine next steps for correction or resubmission, and follow up to move claims toward payment.
• Submit additional documentation or clarification to Medicaid, including adjustments, corrections, and appeals when needed.
• Monitor and manage incoming correspondence (mail, email, electronic notices) and process refunds or adjustments.
• Document all actions on each claim in the billing system for compliance and record-keeping.
• Identify recurring issues or trends and alert management to potential impact on processing timelines.
• Maintain productivity and quality while handling high claim volumes and meeting filing limits.
• Additional duties as assigned.

Skills

MS Outlook

MS Word

MS Excel

Typing 40 WPM

High-volume work

Deadlines

Remote work

Education

High School Diploma or equivalent

Job description

Sarnova HC, LLC is seeking a Medicaid Account Resolution Specialist for Digitech with 100% remote work. You will resolve Medicaid claims after submission, ensuring accurate reimbursement and timely follow-up across the billing lifecycle.

The role requires attention to detail, ability to manage multiple priorities, and commitment to high-quality service for clients and patients. Remote work and a fast-paced environment are core aspects of the job.