Remote Claims Specialist
MediDrive
Job Summary
MediDrive is hiring a Remote Claims Specialist to review transportation claims, validate documentation, resolve claim discrepancies, and support Medicaid transportation operations. This low-phone role combines claims processing, compliance review, denial research, documentation validation, and reporting support.
Job Description
Remote Claims Specialist at MediDrive
MediDrive is seeking a Remote Claims Specialist to support transportation claims processing, documentation review, discrepancy resolution, and compliance activities within its Non-Emergency Medical Transportation (NEMT) program. This position plays an important role in ensuring claims are processed accurately, efficiently, and in accordance with Medicaid requirements and client-specific guidelines.
This Remote Claims Specialist role fits best as a low-phone healthcare operations position. Team members spend most of their day reviewing claims, validating trip information, researching discrepancies, resolving denials, and maintaining accurate records. While communication with transportation providers occurs as part of claims resolution activities, the majority of responsibilities focus on claims processing and documentation review rather than continuous phone work.
Primary responsibilities include reviewing transportation claims for accuracy, validating mileage and service levels, verifying eligibility requirements, and ensuring supporting documentation meets billing standards. Specialists also identify errors, investigate discrepancies, and resolve issues before claims move through the adjudication process.
In addition, team members research denied, rejected, and pended claims to determine root causes and coordinate resolutions. The role involves reviewing system records, authorizations, payment information, and supporting documentation to ensure compliance with Medicaid regulations, HIPAA requirements, and organizational policies.
The position requires strong analytical skills, attention to detail, and the ability to manage multiple priorities in a fast-paced environment. Specialists also support reporting efforts, monitor denial trends, track productivity metrics, identify recurring issues, and recommend process improvements that strengthen claims accuracy and operational efficiency.
Successful candidates typically possess experience in claims processing, healthcare operations, billing support, documentation review, data validation, or compliance-focused environments. Strong organizational skills, problem-solving abilities, and proficiency with Microsoft Office applications are important for success in this role.
MediDrive offers the opportunity to work remotely while supporting healthcare transportation services that help patients access critical medical care. Employees contribute directly to operational excellence through accurate claims management, compliance support, and process improvement initiatives.
Overall, this position is an excellent fit for professionals who enjoy claims review, discrepancy research, documentation validation, compliance monitoring, and healthcare operations within a remote work environment.