Medicare Account Resolution Specialist

Sarnova

. Manage and resolve Medicare claims after submission to ensure accurate and timely processing .

Posted 10/2/2026full-timeRemote • United StatesMid-LevelSeniorWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in managing and resolving Medicare claims, ensuring accurate processing and adherence to deadlines. Proficient in documentation, communication, and organizational skills to support claim adjudication and workflow management.

Highest-signal resume keywords

Medicare Claims ManagementClaims Analysis and AppealsHigh Attention to DetailStrong Written and Verbal CommunicationOrganizational and Time-Management Skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims ProcessingData EntryTyping Speed of 40 WPMDocumentation ManagementError Correction

Soft Skills

ProfessionalismCalm Under PressurePositive Communication

Tools & Technologies

MS OutlookMS WordMS Excel

Industry Keywords

MedicareClaim AdjudicationHigh-Volume WorkloadConfidential Information Security

About the role

Key responsibilities & impact

Manage and resolve Medicare claims after submission to ensure accurate and timely processing
Work pending, unreleased, denied, or incorrectly paid Medicare claims and return them to payment status
Review and resolve claims placed on hold by identifying reasons, correcting errors, and completing follow-up actions
Analyze Medicare denials and complete appeals, adjustments, or resubmissions as needed
Provide Medicare with additional documentation or information required for claim adjudication
Prepare, process, and track letters, emails, supporting documents, and required refunds
Maintain detailed notes, documentation, and workflow updates in billing systems for claim progression and audit requirements
Perform additional duties as assigned

Requirements

What you’ll need

High School Diploma or equivalent required
Strong computer skills with working knowledge of MS Outlook, Word, and Excel
Ability to type a minimum of 40 WPM with accuracy
Proven ability to manage high-volume workloads while meeting strict deadlines
Experience in an environment with call monitoring, productivity metrics, or performance scoring is preferred
Ability to remain calm, professional, and effective during phone interactions while maintaining a positive company image
Excellent written and verbal communication skills, with the ability to explain information clearly and professionally
High attention to detail with strong accuracy in claim review and documentation
Strong organizational and time-management skills with the ability to prioritize work and complete assigned tasks efficiently
Ability to independently manage all aspects of the job role including required goals and business practices in a remote environment
Ability to talk, hear, and see clearly to read and interpret information
Regular use of a computer, phone, and standard office equipment
Ability to secure confidential information
Must work 40 hours per week according to the assigned schedule

Benefits

Comp & perks

Competitive salary, commensurate with experience
Comprehensive benefits package
401(k) Plan
Remote work environment