What You’ll Do:Review and adjudicate Medicare Supplement claims for accuracy, coverage eligibility, and medical necessityAnalyze CPT/billing codes, charges, fee schedules, medical records, and services renderedApprove, deny, or pend claims for additional documentationInvestigate fraud, waste, and abuse (FWA) concerns and support payment integrity effortsHandle denied claims, appeals, and reprocessingServe as a subject matter expert for claims/customer service teams on Medicare guidelines. What You Bring:2–4+ years of Medicare Supplement claims processing experienceStrong knowledge of CMS guidelines, claims adjudication, Medicare Benefit Policy Manual, and reimbursement practicesExperience reviewing medical records, coding, and claims discrepanciesHigh attention to detail, analytical thinking, and accuracy in a high-volume environmentCPC/CMRS certification a plus.