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Medicare Claims Processing Jobs in Kentucky (NOW HIRING)

Amerita

Pharmacy Claims Processor / Remote

Louisville, KY · On-site +1

$15.50 - $19.75/hr

Researches, analyzes and appropriately resolves rejected claims by working with national Medicare D ... Prepares and maintains reports and records for processing * Performs other tasks as assigned ...

PharMerica

Pharmacy Claims Processor / Remote

Louisville, KY · On-site +1

$15.50 - $19.75/hr

Researches, analyzes and appropriately resolves rejected claims by working with national Medicare D ... Prepares and maintains reports and records for processing * Performs other tasks as assigned ...

PharMerica

Pharmacy Claims Processor / Remote

Louisville, KY · On-site +1

$15.50 - $19.75/hr

Researches, analyzes and appropriately resolves rejected claims by working with national Medicare D ... Prepares and maintains reports and records for processing * Performs other tasks as assigned ...

BrightSpring

Pharmacy Claims Processor / Remote

Louisville, KY · Remote

$15.50 - $19.75/hr

Researches, analyzes and appropriately resolves rejected claims by working with national Medicare D ... Prepares and maintains reports and records for processing * Performs other tasks as assigned ...

PharMerica

Pharmacy Claims Processor / Remote

Louisville, KY · On-site +1

$15.50 - $19.75/hr

Researches, analyzes and appropriately resolves rejected claims by working with national Medicare D ... Prepares and maintains reports and records for processing * Performs other tasks as assigned ...

BrightSpring

Pharmacy Claims Processor / Remote

Louisville, KY · Remote

$15.50 - $19.75/hr

Researches, analyzes and appropriately resolves rejected claims by working with national Medicare D ... Prepares and maintains reports and records for processing * Performs other tasks as assigned ...

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Medicare Claims Processing information

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How much do medicare claims processing jobs pay per hour?

As of Aug 19, 2026, the average hourly pay for medicare claims processing in Kentucky is $16.65, according to ZipRecruiter salary data. Most workers in this role earn between $14.18 and $17.93 per hour, depending on experience, location, and employer.

What is Medicare claims processing?

Medicare claims processing refers to the series of steps involved in reviewing, approving, and paying claims for healthcare services provided to Medicare beneficiaries. This process ensures that submitted claims meet Medicare’s rules and regulations and that providers are reimbursed correctly. Claims processors review documentation, verify patient eligibility, check for coding accuracy, and determine coverage based on Medicare guidelines. The process helps to prevent fraud, waste, and abuse while ensuring timely payment to healthcare providers.

What are the key skills and qualifications needed to thrive in Medicare claims processing, and why are they important?

To excel in Medicare Claims Processing, you need strong attention to detail, knowledge of healthcare billing procedures, and familiarity with Medicare regulations, often supported by experience or coursework in medical billing and coding. Proficiency with claims management software, electronic health record (EHR) systems, and understanding of ICD-10 and CPT coding are typically required. Excellent organizational skills, problem-solving abilities, and clear communication help professionals navigate complex claims and resolve issues efficiently. These skills ensure accurate, timely claims processing, minimize errors, and support compliance with Medicare guidelines, ultimately benefiting both providers and patients.

What are some common challenges faced in Medicare claims processing and how can I prepare for them?

Medicare claims processing specialists often encounter challenges such as navigating complex regulations, ensuring timely and accurate data entry, and resolving discrepancies or denials from insurance payers. To prepare, it's helpful to develop strong attention to detail, stay up to date on Medicare guidelines, and become proficient with claims management software. Regular communication with healthcare providers and insurance representatives is also crucial for resolving issues efficiently and ensuring claims are processed correctly.

What is the difference between Medicare Claims Processing vs Medical Billing Specialist?

AspectMedicare Claims ProcessingMedical Billing Specialist
CertificationsTypically requires claims processing training, possibly some Medicare-specific certificationsOften requires medical billing and coding certifications, such as CPC or CMA
Work EnvironmentHealthcare facilities, insurance companies, government agenciesMedical offices, clinics, healthcare billing companies
Job FocusReviewing, submitting, and managing Medicare claims for reimbursementPreparing and submitting medical bills to various insurance providers, including Medicare

Medicare Claims Processing involves handling Medicare-specific claims, ensuring compliance with government regulations. Medical Billing Specialists manage billing for various insurance types, including Medicare, focusing on accurate coding and documentation. While both roles require knowledge of healthcare billing, Medicare Claims Processing is more specialized in Medicare procedures and regulations.

How to get a job as a Medicare claims processor?

To become a Medicare claims processor, candidates typically need a high school diploma or equivalent, with some roles requiring postsecondary education or training in healthcare administration. Relevant skills include attention to detail, knowledge of medical billing and coding, and familiarity with claims processing software. Certification in medical billing or coding can improve job prospects, and positions often require working in a healthcare or administrative environment with standard office hours.

Is Medicare claims processing a stressful job?

Medicare claims processing can be stressful due to strict deadlines, high accuracy requirements, and the need to handle complex regulations. Employees often work in fast-paced environments and must pay close attention to detail, which can contribute to job-related stress.

Is a Medicare Claims Processing job in demand?

Medicare Claims Processing jobs are in demand due to the ongoing need for healthcare administration and the aging population. These roles often require knowledge of healthcare policies and claims software, and employment is expected to grow as healthcare services expand and evolve.

What are popular job titles related to Medicare Claims Processing jobs in Kentucky?

For Medicare Claims Processing jobs in Kentucky, the most frequently searched job titles are:

What job categories do people searching Medicare Claims Processing jobs in Kentucky look for?

The top searched job categories for Medicare Claims Processing jobs in Kentucky are:

Medicare Claims Processing jobs near you
Infographic showing various Medicare Claims Processing job openings in Kentucky as of August 2026, with employment types broken down into 1% As Needed, 78% Full Time, 16% Part Time, 1% Temporary, 3% Contract, and 1% Nights. Highlights an 93% Physical, 2% Hybrid, and 5% Remote job distribution, with an average salary of $34,622 per year, or $16.6 per hour.

Pharmacy Claims Processor / Remote

BrightSpring Health Services

Louisville, KY • Remote

$20 - $23/hr

Full-time

Posted 27 days ago

BrightSpring Health Services rating

4.9

Company rating: 4.9 out of 10

Based on 64 frontline employees who took The Breakroom Quiz

219th of 242 rated social care providers

Job description

Overview

Step Into a Rewarding Role as a Claims Specialist with PharMerica!

Are you ready to make a real impact in a growing organization? Join our PharMerica team as a Claims Specialist, where you'll play a key role in ensuring our long-term care and senior living clients receive the pharmaceutical support they need. We offer a non-retail, closed-door pharmacy environment, allowing you to focus on what truly matters—delivering exceptional care and service.

Why Join PharMerica?

  • Focused on Service Excellence: Our mission is to provide top-quality care and outstanding customer service to hospitals, rehabilitation centers, long-term acute care hospitals, and specialized care centers across the nation.
  • Career Growth: We’re in high growth mode, offering plenty of opportunities for those looking to advance their careers.
  • Remote Flexibility: This position is 100% remote, giving you the freedom to work from anywhere!

What You’ll Do: As a dynamic Claims Specialist, you will:

  • Leverage your Pharmacy Claims Experience to manage and resolve claims efficiently, ensuring our clients get the support they need.
  • Be a vital part of a team that’s dedicated to enhancing patient care through meticulous claims management and customer service.

What We Offer:

  • DailyPay
  • Flexible Schedules
  • Competitive Pay with Shift Differentials
  • Health, Dental, Vision, and Life Insurance
  • Company-Paid Disability Insurance
  • Tuition Assistance & Reimbursement
  • Employee Discount Program
  • 401k Plan
  • Paid Time Off
  • Non-Retail, Closed-Door Environment

Responsibilities

The Claims Specialist - 3rd Party:

  • Manages and identifies a portfolio of rejected pharmacy claims to ensure maximum payer reimbursement and timely billing to eliminate financial risks
  • Researches, analyzes and appropriately resolves rejected claims by working with national Medicare D plans, third party insurance companies and all state Medicaid plans to ensure maximum payer reimbursement adhering to critical deadlines
  • Ensures approval of claims by performing appropriate edits and/or reversals to ensure maximum payer reimbursement
  • Monitors and resolves at risk revenue associated with payer set up, billing, rebilling and reversal processes
  • Works as a team to identify, document, communicate and resolve payer/billing trends and issues
  • Reviews and works to convert billing exception reports to ensure claims are billed to accurate financial plans
  • Prepares and maintains reports and records for processing
  • Performs other tasks as assigned

Qualifications

Education/Learning Experience:

  • Required: High School Diploma or GED
  • Desired: Associate’s or Bachelor’s Degree

Work Experience:

  • Required: Customer Service
  • Desired: Up to one year of related experience. Pharmacy Technician experience

Skills/Knowledge:

  • Required: Ability to retain a large amount of information and apply that knowledge to related situations. Ability to work in a fast-paced environment. Basic math aptitude. Microsoft Office Suite
  • Desired: Knowledge of the insurance industry’s trends, directions, major issues, regulatory considerations and trendsetters

Licenses/Certifications:

  • Desired: Pharmacy technician, but not required

What BrightSpring Health Services employees say

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