Website Medica
About the role
Medica’s Claim Accumulator II helps keep members’ medical and pharmacy benefit records accurate. The work involves reviewing daily reports, correcting discrepancies, and coordinating with internal teams and outside vendors.
Responsibilities
Review accumulator reports, investigate missing or incorrect information, and update records following benefit-plan changes, membership changes, or system corrections. Resolve medical and pharmacy claims issues, submit and monitor system tickets, and report progress or risks to leadership.
Work with operations, technology teams, senior accumulator specialists, and vendors such as Optum and ESI. Participate in process improvements and system enhancements, maintain documentation, and follow company procedures.
Required qualifications
Applicants need a high school diploma or equivalent and at least two years of related work experience.
Preferred qualifications and skills
Experience in healthcare, insurance, claims, or operations is preferred. Helpful experience includes accumulator reporting, medical and pharmacy claims, health-plan benefits, and vendor coordination.
Candidates should understand claims administration, be comfortable with ESI or similar systems, and have basic Microsoft Excel skills. Strong attention to detail, analytical thinking, communication, deadline management, and independent and team working skills are important.
Remote eligibility
Applicants must have their primary home address in Arkansas, Arizona, Florida, Georgia, Iowa, Illinois, Kansas, Kentucky, Michigan, Minnesota, Missouri, North Dakota, Nebraska, Oklahoma, South Dakota, Tennessee, Texas, Virginia, or Wisconsin.
Compensation and benefits
The expected hiring range is $41,300–$61,950 annually. The wider salary grade reaches $70,800, but that is not the stated typical hiring maximum. Placement depends on qualifications and other compensation factors.
Benefits include medical, dental, and vision coverage, paid time off, holidays, paid volunteering time, retirement contributions, and caregiver support.
Work authorization
Applicants must already be authorized to work in the United States. Visa sponsorship is not available. Compensation and benefits may change.