Job Description
Job Title: Medical Claims Coordinator
Job Overview:We are seeking a detail-oriented and experienced Medical Claims Coordinator to support our client’s healthcare operations. This fully remote, contract position (must be in central or eastern time zone) focuses on auditing and adjudicating medical stop loss claims while ensuring compliance with relevant standards and contracts.
Compensation:- $23 – $26/hour, depending on experience
Work Schedule:- Monday through Friday, standard business hours in your time zone
Key Responsibilities of the Medical Claims Coordinator:- Review and audit medical stop loss claims to ensure alignment with plan documents, stop loss contracts, and carrier standards
- Collaborate with finance to facilitate approved claim payments
- Pend or deny claims appropriately and communicate decisions with third-party administrators
- Escalate complex claim issues for clinical or management review
- Maintain thorough and accurate claim documentation
- Generate internal and external reporting and advise on claims development and projections
- Monitor and document claim trends; report findings to leadership
- Perform self-audits and implement improvements to meet accuracy and turnaround goals
- Provide feedback to improve quality and streamline claim review procedures
- Work cross-functionally with other departments to enhance efficiency
Qualifications and Skills for the Medical Claims Coordinator:- High School Diploma or GED required; Bachelor’s degree in Medical Billing and Coding or a related field preferred
- Minimum 5 years of experience in medical claims administration (carrier or provider experience preferred)
- Familiarity with medical terminology and third-party administration processes
- Proficiency in Microsoft Office and other relevant computer applications
- Strong organizational, analytical, and problem-solving skills with keen attention to detail
Why Join Us?This is an exciting opportunity to contribute to a meaningful healthcare mission while enjoying the flexibility of remote work. You'll collaborate with knowledgeable professionals and build your expertise in a supportive, process-focused environment.
About Us:Contemporary Staffing Solutions (CSS) is a trusted leader in providing contract, temporary, temp-to-hire, and direct hire staffing solutions. With decades of experience, we’ve grown from a staffing agency to a nationwide provider of workforce management solutions. Our niche recruitment expertise spans Accounting & Finance, Call Center & Office Support, Human Resources, Sales & Marketing, and Information Technology.
Explore more about CSS and how we connect great talent with exceptional opportunities by visiting www.ContemporaryStaffing.com.
#LI-PSG
#LI-AG1
#LI-Remote
Job Tags
Contract work, Temporary work, Monday to Friday,