Medical Benefits Admin/Claims Processor

Medical Billing Audit Support Specialist (Claims Processor)

Location: San Antonio, TX/ Tampa, FL (On site)
Type: Contract | Full-time
Pay Rate: $20-$25/hr

Role Summary

Acts as the primary liaison and support resource for Injury/Casualty Adjusters supporting Medical Bill Audit (MBA) operations in MedFlow. Provides hands-on claims and system support, helps reduce medical bill backlogs, improves adjuster efficiency, and ensures compliance with service level objectives and state regulations. This is not a traditional IT helpdesk role.

Key Responsibilities

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  Serve as primary point of contact for MBA operations between adjusters, vendors, and claims teams

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  Support adjusters using MedFlow through onboarding, training, and daily issue resolution

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  Assist with high volumes of pending medical bills; identify root causes and recommend improvements

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  Review MBA reports, identify issues, and facilitate resolution per SLOs

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  Maintain user access lists and coordinate access changes with vendors

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  Assist with complaint responses related to medical bill payments

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  Provide light systems support, ticketing, documentation, and issue escalation as needed

Required Skills & Experience

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  1+ year of first-party injury medical claims adjusting or auto liability adjusting experience

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  Experience with medical bill processing, medical terminology, or health insurance claims

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  Working knowledge of claims investigation, evaluation, and adjudication

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  Strong analytical, prioritization, and problem-solving skills

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  Clear written and verbal communication skills

Technology

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  MedFlow Required

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  Guidewire Preferred (training available)

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  Ticketing systems and documentation experience preferred

Ideal Background

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  Claims adjuster with medical billing or MBA experience

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  Health insurance claims processor with system SME experience

• Comfortable in fast-paced, high-communication environments

• Medical Industry knowledge