Claims Compliance Specialist

Job Title: Medical Claims Coordinator

Job Overview:
We are seeking a detail-oriented Medical Claims Coordinator to join our client’s team and play a key role in supporting healthcare operations. This remote, contract position (open to candidates located in CST or EST time zones) focuses on auditing and adjudicating medical claims to ensure compliance with plan documents, contracts, and industry standards.

Compensation:
• $23 – $26/hour, based on experience

Work Schedule:
• Monday through Friday, standard business hours in your time zone

Key Responsibilities of the Medical Claims Coordinator:
• Audit medical claims against plan documents, contracts, and established standards
• Review claim submissions and identify discrepancies or errors
• Document claim files accurately and completely
• Issue approvals, pends, or denials as appropriate and escalate complex cases for review
• Compile regular reporting for both internal and external stakeholders
• Support claim projections and development analysis
• Monitor quality, accuracy, and turnaround time, providing feedback to enhance performance
• Collaborate with cross-functional teams to streamline processes and improve efficiency

Qualifications and Skills for the Medical Claims Coordinator:
• High School Diploma or GED required; Bachelor’s degree in a healthcare or billing-related field preferred
• 5+ years of experience in medical claims administration, auditing, or adjudication
• Strong knowledge of medical terminology and claims processes
• Familiarity with third-party administration functions preferred
• Proficiency in Microsoft Office and other claim management software
• Strong organizational, problem-solving, and analytical skills with exceptional attention to detail

Why Join Us?
This role offers the opportunity to contribute to meaningful healthcare operations by ensuring accuracy and compliance in claims management. If you are meticulous, enjoy problem-solving, and want to leverage your medical claims expertise in a fully remote role, this position is an excellent fit.

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.