Claims Examiner

About the Opportunity

Vaco Atlanta is partnering with a stable, mission-driven organization to hire a Medicare Claims Examiner. In this role, your expertise in claims adjudication will directly protect members and ensure payment integrity. The position is based onsite in Chamblee and offers a permanent opportunity within a collaborative healthcare environment focused on accuracy, compliance, and fraud prevention.

The Role

You will serve as a subject matter expert for claims and customer service teams, reviewing and adjudicating Medicare Supplement claims to verify accuracy, coverage eligibility, and medical necessity. Your day-to-day work involves analyzing CPT/billing codes, charges, fee schedules, and medical records to approve, deny, or pend claims for additional documentation. You will also investigate fraud, waste, and abuse (FWA) concerns, handle denied claims and appeals, and support broader payment integrity efforts.

This role is ideal for someone passionate about high-impact work who wants to influence process improvements in a stable industry with career growth potential.

Hiring Process

Submissions to this position are subject to preliminary candidate screenings using AI to ensure minimum job requirements are met. Further assessment beyond this initial phase will be conducted by recruiters and hiring managers. By submitting your application, you agree to be included in the talent pool for future hiring for similarly qualified positions.

Equal Opportunity & Culture

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. We are an Equal Opportunity Employer committed to the full inclusion of all qualified individuals and do not discriminate based on race, color, sex, religion, national origin, age, disability, veteran status, or any other protected characteristic.

If reasonable accommodation is needed to participate in the application or interview process, please contact HR@vaco.com.