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RAM Health

Medicare Advantage Claims Processor

Remote · United States · Full time · Mid level

$18–$20 / hour

About the role

Perform reviews and adjudication of Medicare Advantage claims remotely. Ensure claims meet regulatory and client standards while supporting data submission and inquiries.

What you’ll do

• Perform timely and accurate claim adjudication and adjustments. • Adjudicate specialty claims including surgery, nursing, dental, anesthesia. • Prepare encounters for submission and correct rejected encounters. • Support system inquiries from member and provider call centers. • Research and review Claims Appeals to support client inquiries.

What you’ll bring

• 1-3 years healthcare experience in Medicare Advantage or Managed Medicaid. • Experience in BPaaS environment is a plus. • Ability to meet production and performance standards. • Attention to detail and ability to apply documented procedures. • High School Diploma required, MS Word and Excel skills needed.

Life at RAM Health

Offers competitive hourly pay, 100% remote work, health benefits, 401k with match, tuition reimbursement, and parental leave.

About RAM Health

RAM Health simplifies healthcare administration with technology-driven solutions to improve government-sponsored health plans' performance and reduce costs.

Posted 3 hours ago