Senior Medical Claims Specialist: Lead & Impact

Redirect Health Inc; Phoenix (AZ); Hybrid; USD 50,000 - 55,000; Full time

Benefits offered by this job

Free healthcare for you and your whole

Dental & Vision insurance

401(k) access

Paid time off & sick time

Job summary

Redirect Health is seeking a Senior Medical Claims Processor to review, process, and adjudicate complex medical claims with accuracy and policy alignment. You will support junior staff, oversee workflow, and handle appeals, COBs, and provider relations in a hybrid work setting.

You should have 3–5 years of claims processing experience, strong knowledge of ICD-10, CPT, HCPCS, and payer guidelines, plus experience with EHR/claims systems.

Qualifications

• High school diploma required; associate/bachelor degree preferred.
• 3–5 years of medical claims processing experience.
• Strong knowledge of ICD-10, CPT, HCPCS and payer guidelines.
• Experience with EHR/claims processing systems.

Responsibilities

• Review and process medical claims with high accuracy and efficiency.
• Handle manual/complex reprocessing and appeals.
• Interpret benefit plans and payer guidelines for adjudication.
• Coordinate with providers and manage COBs and settlements.
• Oversee daily workflow and mentor junior staff.

Skills

Analytical skills

Attention to detail

Leadership

Mentoring

Time management

Education

High school diploma

Associate's or Bachelor's degree preferred

Tools

EHR/claims processing systems

Job description

Redirect Health is seeking a Senior Medical Claims Processor to review, process, and adjudicate complex medical claims with accuracy and policy alignment. You will support junior staff, oversee workflow, and handle appeals, COBs, and provider relations in a hybrid work setting.

You should have 3–5 years of claims processing experience, strong knowledge of ICD-10, CPT, HCPCS, and payer guidelines, plus experience with EHR/claims systems.