Claims Examiner

Overview

Vaco Atlanta is hiring a Medicare Supplement Claims Examiner for a growing and established company. Our client seeks 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.

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.

Determining compensation for this role (and others) at Vaco/Highspring depends upon a wide array of factors including but not limited to the individual s skill sets, experience and training, licensure and certifications, office location and other geographic considerations, as well as other business and organizational needs. With that said, as required by local law in geographies that require salary range disclosure, Vaco/Highspring notes the salary range for the role is noted in this job posting.

The individual may also be eligible for discretionary bonuses, and can participate in medical, dental, and vision benefits as well as the company s 401(k) retirement plan. Additional disclaimer:
Unless otherwise noted in the job description, the position Vaco/Highspring is filing for is occupied. Please note, however, that Vaco/Highspring is regularly asked to provide talent to other organizations. By submitting to this position, you are agreeing to be included in our talent pool for future hiring for similarly qualified positions. Submissions to this position are subject to the use of AI to perform preliminary candidate screenings, focused on ensuring minimum job requirements noted in the position are satisfied.

Further assessment of candidates beyond this initial phase within Vaco/Highspring will be otherwise assessed by recruiters and hiring managers. Vaco/Highspring does not have knowledge of the tools used by its clients in making final hiring decisions and cannot opine on their use of AI products.

Vaco by Highspring values a diverse workplace and strongly encourages women, people of color, LGBTQ+ individuals, people with disabilities, members of ethnic minorities, foreign-born residents, and veterans to apply.

Vaco by Highspring is an Equal Opportunity Employer and does not discriminate against any employee or applicant for employment because of race (including but not limited to traits historically associated with race such as hair texture and hair style), color, sex (includes pregnancy or related conditions), religion or creed, national origin, citizenship, age, disability, status as a veteran, union membership, ethnicity, gender, gender identity, gender expression, sexual orientation, marital status, political affiliation, or any other protected characteristics as required by federal, state or local law.

Vaco by Highspring and its parents, affiliates, and subsidiaries are committed to the full inclusion of all qualified individuals. As part of this commitment, Vaco by Highspring and its parents, affiliates, and subsidiaries will ensure that persons with disabilities are provided reasonable accommodations. If reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact

Vaco by Highspring also wants all applicants to know their rights that workplace discrimination is illegal.

By submitting to this position, you agree that you will be giving Vaco by Highspring the exclusive right to present your as a candidate for the foregoing employment opportunity. You further agree that you have represented information about yourself accurately and have not…