Claims Examiner

Vaco Atlanta is hiring a Medicare Supplement Claims Examiner for a growing and established company. Our client is seeking an experienced claims examiner to ensure accurate claims adjudication, protect payment integrity, and help prevent fraud, waste, and abuse. This role blends technical claims expertise with analytical thinking and collaboration—ideal for someone who takes pride in accuracy, compliance, and ethical healthcare billing.

Position: Claims Examiner, Medicare Supplement
Location: Brookhaven, GA
Job Type: Direct Hire
Onsite: 100% onsite
Compensation: $55,000 - $65,000 annually

• Review and adjudicate Medicare Supplement claims in strict adherence to CMS guidelines.
• Analyze coverage, medical necessity, and billing accuracy; approve, deny, or request additional information.
• Identify and investigate potential fraud, waste, or abuse and partner with internal teams on resolution.
• Ensure payment accuracy and prevent over payments or errors.
• Support Customer Service Representatives with guidance on complex claims and appeals.
• Contribute to process improvements, cost savings, and efficiency initiatives.

• 2-4 years of Medicare Supplement claims processing experience.
• Strong knowledge of Medicare Supplement plans, 837 EDI transactions, DME claims, and CMS regulations.
• Bachelor's degree in healthcare administration, business, or related field (or equivalent experience).
• Exceptional attention to detail, analytical skills, and integrity.
• Proficiency with claims systems and Microsoft Office.

• High-impact role supporting payment integrity and compliance.
• Collaborative environment with opportunities to improve processes and outcomes.
• Meaningful work ensuring accurate, ethical healthcare reimbursement.