Medical Claims Specialist
Rocky Mountain Health Care ServicesColorado Springs, Colorado, United States
Posted February 10, 2026
21.09 - 24.25
Full Time
About the Company
Rocky Mountain Health Care Services provides comprehensive primary, specialty, and home health care throughout the Rocky Mountain region. The organization employs a multidisciplinary team to deliver patient‑centered care for acute and chronic conditions, emphasizing seamless coordination across its integrated care network. Strong partnerships with local hospitals and community organizations enable smooth transitions and coordinated service delivery. The company’s commitment to quality, accessibility, and community health improvement sets it apart in the regional health care market.
Job Description
Medical Claims Processors are responsible for processing, adjudicating, and paying all program participant medical insurance claims.
Requirements
- Processes provider claims including validation, coding, data entry, adjudication, and importing/exporting in claims management systems.
- Prepares and disburses payment checks with explanation of payments (EOPs) to providers
- Performs in depth analysis of complex claims identifying missing and/or incomplete data to determine appropriate resolution
- Acts as the primary contact for support and resolution with internal departments, program participants as well as external provider representatives for questions about claim status, appeals, etc
