**Experienced Medical Reimbursement & Claims Specialist – Remote Opportunity with Competitive Hourly Rate and Comprehensive Benefits Package**
Remote, USAFull-timePosted 2025-11-03
About Our Company
At [Company Name], we are a leading provider of innovative solutions in the pharmaceutical industry. Our mission is to make a positive impact on people's lives by delivering exceptional products and services. We are committed to fostering a culture of excellence, collaboration, and growth, where our employees can thrive and reach their full potential.
About the Role
We are seeking an experienced Medical Reimbursement & Claims Specialist to join our remote team. As a key member of our team, you will play a vital role in ensuring the smooth processing of medical claims, providing exceptional customer service, and driving business growth. This is an exciting opportunity for a motivated and detail-oriented individual to join our dynamic team and contribute to our mission.
Key Responsibilities
* Process medical claims via electronic fax, ensuring accuracy and efficiency
* Perform medical benefits investigations, gathering and reviewing patient billing and medical information
* Use computer skills for data entry, operating according to the guidelines of the Federal Health Care Program
* Work with carriers to ensure coverage of medication on behalf of the patient
* May perform some outbound calls and take some inbound calls assisting patients with medical-related inquiries
* Collaborate with internal stakeholders to resolve claims-related issues and improve processes
Essential Qualifications
* 1 year or more of medical benefits experience (no exceptions)
* High school diploma or equivalent
* Ability to multi-task and use dual monitors
* Great work attitude and willingness to help others
* Strong communication and interpersonal skills
* Ability to work in a fast-paced environment and meet deadlines
Preferred Qualifications
* Medical call center experience (not required but a plus)
* Experience working with electronic medical records (EMRs) and claims management systems
* Knowledge of Federal Health Care Program guidelines and regulations
* Certification in medical billing or coding (e.g., CPC, CMC)
Skills and Competencies
* Strong analytical and problem-solving skills
* Excellent communication and interpersonal skills
* Ability to work independently and as part of a team
* Strong attention to detail and accuracy
* Ability to adapt to changing priorities and deadlines
* Proficiency in Microsoft Office and Google Suite
* Familiarity with claims management software and electronic medical records (EMRs)
Career Growth Opportunities and Learning Benefits
At [Company Name], we believe in investing in our employees' growth and development. As a Medical Reimbursement & Claims Specialist, you will have opportunities to:
* Develop your skills and expertise in medical reimbursement and claims management
* Collaborate with internal stakeholders to improve processes and drive business growth
* Participate in training and development programs to enhance your knowledge and skills
* Take on additional responsibilities and contribute to the success of our team
Work Environment and Company Culture
As a remote employee, you will have the flexibility to work from the comfort of your own home. Our company culture is built on collaboration, innovation, and mutual respect. We value diversity, equity, and inclusion and strive to create a workplace where everyone feels welcome and supported.
Compensation, Perks, and Benefits
We offer a competitive hourly rate of $19 per hour, paid weekly. In addition to your salary, you will also receive:
* Comprehensive benefits package, including medical, dental, and vision insurance
* 401(k) retirement plan with company match
* Paid time off and holidays
* Opportunities for professional development and growth
* Flexible work arrangements and remote work options
How to Apply
If you are a motivated and detail-oriented individual with a passion for medical reimbursement and claims management, we encourage you to apply for this exciting opportunity. Please submit your resume and a cover letter to [email protected], mentioning "($19/hr. CMS)" in the email subject line. We look forward to hearing from you!
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