Medical Claims & Eligibility Coordinator

Title: Medical Claims & Eligibility Coordinator
Location: Nashville TN - Hybrid
Duration: 12 Months W2 Role

Position Summary
Responsible for supporting the administration of medical service payments client eligibility processing vendor coordination and payment denials under the Ryan White Part B program. Ensures accurate documentation compliance with program requirements and timely processing of invoices and eligibility applications.

Key Responsibilities

• Review and process medical service invoices verify client eligibility and ensure compliance with payer-of-last-resort requirements.
• Enter invoices into PTBMIS to authorize payments and monitor payment processing status.
• Assist with payment denials including vendor correspondence tracking and recoupment procedures.
• Maintain and distribute updated Ryan White Part B Fee Schedules.
• Assist with the annual Authorization to Vendor process and maintain related documentation.
• Review and process client eligibility applications through the Ryan White Eligibility System (RWES).
• Maintain accurate records and ensure compliance with program policies procedures and confidentiality requirements.
• Perform other related duties as assigned.

Please send resumes to to apply!

Required Experience:

IC