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Medicare Account Resolution Specialist - Digitech - Remote

Sarnova HC LLC

Remote · USJobSeen 2 days agoSeen in employer's feed 2 days ago

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At a glance

Compensation
No compensation found
Location
Remote · US
Work Authorization
Not specified

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Job overview

The Medicare Account Resolution Specialist manages Medicare claims after submission to support accurate and timely processing. The role resolves pending, held, denied, or incorrectly paid claims by reviewing issues, completing follow-up, and pursuing appeals, adjustments, or resubmissions. It also handles claim correspondence and maintains billing-system documentation. The ideal candidate is thorough, dependable, and skilled at navigating Medicare guidelines, denials, and follow-up processes.

Skills & qualifications

RequiredNice to have

Skills

Medicare GuidelinesClaims ResolutionComputer SkillsMicrosoft OutlookMicrosoft WordMicrosoft ExcelTypingWorkload ManagementPhone CommunicationWritten CommunicationVerbal CommunicationAttention to DetailOrganizationTime ManagementPrioritizationIndependent WorkConfidential Information Handling

Qualifications

High School Diploma or Equivalent40 Wpm TypingCall Monitoring or Productivity Metrics Experience

Full job description

Sarnova HC, LLC Position Title: Medicare Account Resolution Specialist - Digitech - Remote Job Description The Sarnova Family of companies includes Digitech Computer, Bound Tree Medical, Tri-anim Health Services and Cardio Partners. Digitech is a leading provider of advanced billing and technology services to the EMS transport industry. Since its founding in 1984, Digitech has refined its software platform to create a cloud-based billing and business intelligence solution that monitors and automates the entire EMS revenue lifecycle. Digitech leverages its proprietary technology to offer fully outsourced services that maximize collections, protect compliance, and deliver results for clients. Summary: The Medicare Account Resolution Specialist is responsible for managing and resolving Medicare claims after submission to ensure accurate and timely processing. This role requires strong analytical skills, exceptional attention to detail, and the ability to manage multiple tasks in a fast-paced billing environment. The ideal candidate is thorough, dependable, and skilled at navigating Medicare guidelines, denials, and follow-up processes. Essential Duties and Responsibilities: - 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 all required follow-up actions - Analyze Medicare denials to determine accuracy, identify next steps, and complete appeals, adjustments, or resubmissions as needed - Provide Medicare with any 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 - Additional job duties as assigned Skills/Experience Required: - Education: 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 Physical Requirements: - 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 - Perform all duties in a professional environment free of noise or anything that would create a negative customer experience Work environment characteristics described here are representative of those that must be met by an employee to successfully perform the essential function of this job. Re

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