Medical Claims & Eligibility Coordinator

Title: Medical Claims & Eligibility Coordinator

Location: Nashville, TN - Hybrid

Duration: 12 Months – W2 Role

Position Summary

Responsible for supporting the administration of medical service payments, client eligibility processing, vendor coordination, and payment denials under the Ryan White Part B program. Ensures accurate documentation, compliance with program requirements, and timely processing of invoices and eligibility applications.

Key Responsibilities

• Review and process medical service invoices, verify client eligibility, and ensure compliance with payer-of-last-resort requirements.
• Enter invoices into PTBMIS to authorize payments and monitor payment processing status.
• Assist with payment denials, including vendor correspondence, tracking, and recoupment procedures.
• Maintain and distribute updated Ryan White Part B Fee Schedules.
• Assist with the annual Authorization to Vendor process and maintain related documentation.
• Review and process client eligibility applications through the Ryan White Eligibility System (RWES).
• Maintain accurate records and ensure compliance with program policies, procedures, and confidentiality requirements.
• Perform other related duties as assigned.

Please send resumes to usjobs@mavensoft.com to apply!