Remote Medicare Claims Resolution Specialist

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

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.