Remote Medical Benefits Review Specialist

Conduent; Orangeburg (SC); Remote; USD 34,000 - 43,000; Full time

Benefits offered by this job

Benefits day 1

Fully remote position

Flexible schedule

Job summary

Conduent is seeking a Medical Benefits Review Associate to support Medicare, Medicaid, and Commercial claim overpayments remotely. The role emphasizes analytical review of claims and eligibility, with a focus on accurate, high-quality work within a fast-paced remote environment.

You will review paid/adjusted/offset claims, verify member eligibility, and document findings while communicating with a remote team. Strong data-entry, computer, and insurance knowledge are essential.

Qualifications

• Must be 18 or older to apply.
• Must have a high school diploma or GED.
• Must be able to pass preemployment background check and drug screening.
• Background in benefit/coverage concepts desired.
• Basic knowledge of insurance procedures, working with insurance carriers, Medicare, and Medicaid.
• Experience with data entry / medical claims data entry processing.
• Professional verbal and written communication skills required.
• Proficiency with Microsoft Office (Word, Excel, and Outlook).
• Understanding of medical terminology and healthcare eligibility processes.
• Strong investigative, research, and critical thinking skills.
• Excellent verbal and written communication skills.
• Strong organizational and multitasking abilities.
• Ability to work independently while collaborating effectively with a remote team.

Responsibilities

• Review of paid claims, adjusted claims, and offset claims in the client system.
• Review of member eligibility, update of member eligibility.
• Investigates and communicates questionable situations.
• Documents findings from the client system in the related systems.
• Communicate effectively with other staff/team members.
• Works independently based on established procedures.

Skills

Analytical skills

Investigative thinking

Verbal and written communication

Independent work (remote)

Data entry / claims processing

Medical terminology understanding

Education

High school diploma or GED

Background in benefit/coverage concepts

Tools

Microsoft Office (Word, Excel, Outlook)

Job description

Conduent is seeking a Medical Benefits Review Associate to support Medicare, Medicaid, and Commercial claim overpayments remotely. The role emphasizes analytical review of claims and eligibility, with a focus on accurate, high-quality work within a fast-paced remote environment.

You will review paid/adjusted/offset claims, verify member eligibility, and document findings while communicating with a remote team. Strong data-entry, computer, and insurance knowledge are essential.