Medicare Account Resolution Specialist

Sarnova

. Work Medicare claims that are pending, unable to be released, denied, or paid incorrectly, ensuring each claim is resolved appropriately and returned to payment status .

Posted 10/27/2026full-timeRemote • United StatesMid-LevelSeniorWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in managing Medicare claims, including resolving denials, processing appeals, and maintaining accurate documentation. Strong organizational skills and attention to detail are essential for managing high-volume workloads and meeting deadlines in a remote environment.

Highest-signal resume keywords

Medicare Claims ManagementClaim Denial AnalysisDocumentation AccuracyHigh-Volume Workload ManagementExcellent Written And Verbal Communication

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims ProcessingData EntryTyping Speed Of 40 WPMMicrosoft OutlookMicrosoft WordMicrosoft ExcelClaim AdjudicationAppeals ProcessingError CorrectionWorkflow Management

Soft Skills

Attention To DetailOrganizational SkillsTime ManagementProfessionalismCalm Under Pressure

Certifications & Qualifications

High School Diploma Or Equivalent

Industry Keywords

MedicareClaims ReviewPerformance MetricsConfidential Information SecurityRemote Work Environment

About the role

Key responsibilities & impact

Work Medicare claims that are pending, unable to be released, denied, or paid incorrectly, ensuring each claim is resolved appropriately and returned to payment status
Review and resolve claims placed on hold by identifying the reason for the hold, correcting errors, and completing required follow-up actions
Analyze Medicare denials to determine accuracy, identify next steps, and complete appeals, adjustments, or resubmissions as needed
Provide Medicare with additional documentation or information necessary for accurate claim adjudication
Prepare, process, and track correspondence such as letters, emails, supporting documents, and required refunds
Maintain detailed and accurate notes, documentation, and workflow updates within billing systems to support claim progression and audit requirements
Perform additional job 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
Ability to work in a professional environment free of noise or anything that would create a negative customer experience
Ability to work forty (40) hours per week as defined by the schedule

Benefits

Comp & perks

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