REMOTE POSITION / CLAIMS PROCESSOR

Medical Claims Specialist II (COB & Medicare Coordination) Remote Work
5-Month Contract

We are seeking an experienced Medical Claims Specialist II with strong knowledge of medical claims processing and Coordination of Benefits (COB) . The ideal candidate will have experience determining the correct order of payment between Medicare and commercial insurance plans , researching claim discrepancies, and resolving payment issues while maintaining compliance with healthcare regulations.
Apply today if you have medical claims processing experience and a strong understanding of Coordination of Benefits (COB) and Medicare payment rules.
We're looking for someone who has hands-on experience reviewing medical claims, applying COB rules, identifying primary versus secondary coverage, and working with Medicare and commercial insurance carriers to ensure accurate claim payments and recoveries.

Process and review medical claims accurately and efficiently
Research and resolve claim edits, denials, and payment discrepancies
Analyze and adjust previously processed claims as needed
Initiate recovery and refund processes for overpaid claims
Review and update COB records based on Medicare and commercial carrier rules
Maintain accurate claim documentation and records
Ensure compliance with HIPAA, regulatory requirements, and company policies
Assist with special projects, audits, and process improvement initiatives
Medical claims processing and knowledge of how to determine primacy (order of payment) with Medicare and other commercial carriers.”
High School Diploma or equivalent
Minimum 2 years of medical claims processing experience
Knowledge of Medicare and commercial insurance coordination rules
Proficiency with claims processing systems and Microsoft Office applications
Experience adjusting claims and recovering overpayments
Healthcare payer or health insurance industry experience
Pay Rate: $20.00 per hour
Duration: 5-Month Contract
Schedule: Full-Time
Fully Remote
We're looking for someone who has hands-on experience reviewing medical claims, applying COB rules, identifying primary versus secondary coverage, and working with Medicare and commercial insurance carriers to ensure accurate claim payments and recoveries.