Remote Medicare Claims Processor

Step Into the Role That Powers Healthcare Access

Are you ready to take charge of your future while playing a vital role in the nation’s healthcare system? As a Remote Medicare Claims Processor, you'll ensure the smooth and accurate handling of Medicare-related claims, enabling patients to access their benefits without delay. This opportunity is more than just a job—it's a meaningful way to make an impact from anywhere. With an annual salary of $53,323, this fully remote position offers both financial security and personal fulfillment. Join a mission-driven team and contribute to something that matters every single day.

A Mission Built on Service and Progress

This team is rapidly growing with a commitment to transforming healthcare support services through innovation and empathy. By joining us, you become a part of an energetic force focused on elevating claim accuracy, reducing turnaround time, and delivering peace of mind to Medicare beneficiaries nationwide. Your skills will support a larger vision—streamlined services, improved access, and better outcomes.

Your Key Responsibilities

Ensure Timely and Accurate Processing

• Review and process Medicare Part A, B, and D claims submitted electronically or via mail
• Interpret coding, billing, and documentation per CMS guidelines
• Validate eligibility, benefit coverage, and reimbursement rates

Maintain Regulatory Compliance

• Adhere to all CMS regulations and data privacy policies
• Keep current with Medicare policy changes to ensure audit readiness
• Document actions taken with clarity and completeness in internal systems

Collaborate Across Teams

• Partner with audit, quality control, and appeals teams to resolve complex claims
• Escalate problematic trends or potential fraud indicators to the compliance department.
• Respond to inquiries from beneficiaries and providers with empathy and professionalism.

Support Continuous Improvement

• Offer feedback on system inefficiencies and recommend enhancements
• Contribute to case studies, performance metrics, and claims data analysis
• Participate in process improvement workshops and monthly training refreshers

What You Bring to the Table

Education and Experience

• Completion of secondary education is essential; additional coursework or a diploma in healthcare support services is considered advantageous.
• Minimum of 2 years of experience in health insurance claims processing, with a focus on Medicare preferred.

Specialized Knowledge

• Familiarity with CMS billing rules, ICD-10, CPT, and HCPCS codes
• Strong understanding of electronic claims systems and Medicare adjudication processes

Skills That Set You Apart

• Detail-oriented with exceptional organizational abilities
• Fast, accurate typing and data entry skills
• Outstanding written and verbal communication
• Analytical thinking with flexibility to respond swiftly in dynamic work settings

Tech Stack and Tools You’ll Use

• Claims Processing Software (i.e., Facets, Amisys, or similar)
• Medicare Administrative Contractor (MAC) Portals
• HIPAA-compliant communication platforms
• Workflow tracking systems and audit dashboards

Your Remote Work Environment

This fully remote position enables you to work from the comfort of your own home while remaining fully integrated with a collaborative and driven team. Daily check-ins, peer mentoring sessions, and quarterly performance updates ensure that you stay engaged and connected. You'll receive all the equipment you need to be productive and secure, including:

• Company-issued laptop and dual monitor setup
• Encrypted access to claims systems
• VPN connection and IT helpdesk support

Exciting Perks That Keep You Energized

• ✨ Competitive Salary – Earn $53,323 annually with regular performance-based reviews
• 💼 100% Remote – Work from anywhere in the U.S. with flexible scheduling options
• 🌿 Health & Wellness – Comprehensive medical, dental, and vision plans
• 🎓 Learning Stipend – Annual allowance for certifications and online courses
• 🌴 Flexible Time Off – Enjoy 20+ days of vacation leave and recognized holidays
• 🚀 Career Growth – Defined promotion tracks and leadership development workshops

Growth and Advancement Opportunities

As you refine your expertise in Medicare claim administration, you’ll unlock new career pathways. Whether you aspire to specialize in auditing, join the appeals team, or move into training and leadership roles, we support your vision for advancement. You'll receive personalized development plans, mentoring, and cross-functional exposure to reach your professional goals.

Take Charge of Your Future Today

Are you ready to do meaningful work that directly impacts lives? Do you want a role that values both precision and purpose? Your next big opportunity awaits—apply now! Join a passionate remote team where your skills drive change and your growth is unstoppable.