Medicare Specialist Jobs
Medicare Specialist jobs are open across health insurance, managed care, government agencies, and healthcare systems, from entry-level billing roles to senior compliance and appeals specialists, with concentrations in claims processing, enrollment coordination, and regulatory compliance. Find a role that fits below and apply directly.
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Showing 5 of 14+ Medicare Specialist jobs
We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.
Title: Patient Relations Analyst
Company: Oak Street Health
Role Description:
The purpose of the Patient Relations Analyst (PRA) at Oak Street Health is to educate patients about Medicare programs, resources, and affordable insurance coverage options available to them in order to increase patient access to care and retention.
Patient Relations Analysts (PRAs) are an integral part of the Oak Street Health care team. Patient Relations Analysts are the insurance experts at each clinic and advocate for patients by helping them navigate through insurance options and bills. They are also a resource to the care team and outreach team for questions regarding medicare and eligibility.
Patient Relations Analysts are daily key players, particularly during Medicare's Open Enrollment, ensuring that our patients are informed of all their options surrounding Medicare. The Patient Relations Analysts will report to the Associate Patient Relations Manager or Practice Manager.
Responsibilities:
- Assist patients with navigating medicare and insurance issues which includes coverage, benefits, summaries, eligibility and getting the most out of their plan
- Serve as internal resource in the clinic on insurance questions for providers and staff
- Assist patients in navigating the healthcare system, help patients resolve medical bills inside and outside of Oak Street Health (advocate for the patient)
- Gain the trust of Oak Street Health patients in an effort to properly advise them in their healthcare coverage
- Manage the welcome visit and orientation process for new Oak Street Health patients
- Educate patients on how to apply for public benefits, such as Public Aid, and Extra Help for prescription drugs
- Support the clinic management team on operational activities as needed, including scheduling and billing
- Provide exceptional customer service
- Foster patient engagement through the design and execution of events, including center tours
- Other duties as assigned
What we're looking for
Required Qualifications:
- Computer Skills: Ability to quickly navigate and use multiple computer programs to include, but not limited to: Gmail, MS Word or Google Docs, Excel, etc.
- US work authorization
Strongly Preferred Qualifications:
- Proficiency in non-English languages like Spanish, Polish, Russian, or other languages spoken by people in the communities we serve (where necessary) as required by center's demographics
Preferred Qualifications:
- Experience with helping patients or customers understand their insurance coverage
- A passion for working with others to create an unmatched patient experiences
- A problem-solving orientation and a flexible and positive attitude
- Sales background preferred
- Experience with and a supportive attitude toward our patient population of older adults
- CRM experience a plus
- Bachelor degree preferred, or equivalent experience
- Experience helping patients navigate the health care system, especially related to Medicare and Managed Care
Anticipated Weekly Hours
40Time Type
Full timePay Range
The typical pay range for this role is:
$21.10 - $40.90This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Great benefits for great people
We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.
This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.
Additional details about available benefits are provided during the application process and on Benefits Moments.
We anticipate the application window for this opening will close on: 04/12/2027
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.
Title: Patient Relations Analyst
Company: Oak Street Health
Role Description:
The purpose of the Patient Relations Analyst (PRA) at Oak Street Health is to educate patients about Medicare programs, resources, and affordable insurance coverage options available to them in order to increase patient access to care and retention.
Patient Relations Analysts (PRAs) are an integral part of the Oak Street Health care team. Patient Relations Analysts are the insurance experts at each clinic and advocate for patients by helping them navigate through insurance options and bills. They are also a resource to the care team and outreach team for questions regarding medicare and eligibility.
Patient Relations Analysts are daily key players, particularly during Medicare's Open Enrollment, ensuring that our patients are informed of all their options surrounding Medicare. The Patient Relations Analysts will report to the Associate Patient Relations Manager or Practice Manager.
Responsibilities:
- Assist patients with navigating medicare and insurance issues which includes coverage, benefits, summaries, eligibility and getting the most out of their plan
- Serve as internal resource in the clinic on insurance questions for providers and staff
- Assist patients in navigating the healthcare system, help patients resolve medical bills inside and outside of Oak Street Health (advocate for the patient)
- Gain the trust of Oak Street Health patients in an effort to properly advise them in their healthcare coverage
- Manage the welcome visit and orientation process for new Oak Street Health patients
- Educate patients on how to apply for public benefits, such as Public Aid, and Extra Help for prescription drugs
- Support the clinic management team on operational activities as needed, including scheduling and billing
- Provide exceptional customer service
- Foster patient engagement through the design and execution of events, including center tours
- Other duties as assigned
What we're looking for
Required Qualifications:
- Computer Skills: Ability to quickly navigate and use multiple computer programs to include, but not limited to: Gmail, MS Word or Google Docs, Excel, etc.
- US work authorization
Strongly Preferred Qualifications:
- Proficiency in non-English languages like Spanish, Polish, Russian, or other languages spoken by people in the communities we serve (where necessary) as required by center's demographics
Preferred Qualifications:
- Experience with helping patients or customers understand their insurance coverage
- A passion for working with others to create an unmatched patient experiences
- A problem-solving orientation and a flexible and positive attitude
- Sales background preferred
- Experience with and a supportive attitude toward our patient population of older adults
- CRM experience a plus
- Bachelor degree preferred, or equivalent experience
- Experience helping patients navigate the health care system, especially related to Medicare and Managed Care
Anticipated Weekly Hours
40Time Type
Full timePay Range
The typical pay range for this role is:
$21.10 - $40.90This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Great benefits for great people
We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.
This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.
Additional details about available benefits are provided during the application process and on Benefits Moments.
We anticipate the application window for this opening will close on: 04/12/2027
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
Medicare Specialist Jobs by Experience Level
See All 14 Medicare Specialist Jobs
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Find Medicare Specialist JobsMedicare Specialist Job Market
Who's Hiring
What Employers Look For
The qualifications that appear most often in medicare specialist jobs.
- Knowledge of Medicare billing guidelines, coverage policies, and CMS regulations
- Experience with Medicare claims processing, denials management, and appeals
- Proficiency in ICD-10-CM and CPT coding as applied to Medicare claims
- Familiarity with Medicare Advantage, Part A, Part B, and Part D plan structures
- Experience using healthcare revenue cycle or claims management software
- Associate or bachelor's degree in health information management, healthcare administration, or a related field
Tips for Your Medicare Specialist Job Search
Tailor your resume to Medicare terminology
Hiring managers scan for specific language like Medicare Advantage, Part D, CMS guidelines, and EOB reconciliation. If your resume uses generic billing terms instead of Medicare-specific ones, it will likely be filtered out before a human sees it.
Highlight your CMS regulatory knowledge
Employers want specialists who understand Centers for Medicare and Medicaid Services rules, not just general insurance processes. Call out your familiarity with the Medicare Benefit Policy Manual or coverage determination processes to separate your application from generalist billing candidates.
Apply early to roles that fit
Migrate Mate lists medicare specialist openings from across the United States in one place, so you can find roles that match and apply directly to each listing.
Target openings by payer mix and setting
A medicare specialist role at a managed care organization looks very different from one at a hospital revenue cycle department or a solo physician practice. Reading the job description for payer mix details helps you apply to roles where your specific experience is actually relevant.
Prepare for scenario-based interview questions
Interviewers for medicare specialist roles frequently present claim denial scenarios or coordination-of-benefits cases and ask how you would resolve them. Reviewing recent CMS denial code updates and walking through your appeal decision logic out loud is the most direct preparation.
Negotiate using your certification credentials
If you hold a CPC, CPMA, or RHIT credential, name it explicitly in offer negotiations. Certified candidates take on compliance risk that uncertified hires cannot, and that responsibility has a concrete value you can reference when discussing your offer.
Medicare Specialist Jobs: Frequently Asked Questions
Which companies are hiring the most medicare specialists?
The most active employers for medicare specialists right now are Sutherland, Infinx, and Peraton, and the most openings are in Texas, California, and Maryland, based on current listings on Migrate Mate as of November 2026. Managed care organizations and large hospital revenue cycle departments tend to post the highest volume of these roles consistently.
How many medicare specialist jobs are remote?
About 67% of medicare specialist openings are fully remote or hybrid as of November 2026, reflecting how much of the role depends on digital claims systems rather than in-person contact. Claims processing, enrollment coordination, and appeals roles have the highest concentration of remote-eligible postings, while compliance auditing roles more often require on-site presence.
How do you become a medicare specialist?
Start by earning a degree or certificate in health information management, medical billing, or healthcare administration. Gain hands-on experience with claims processing in any payer environment, then focus specifically on Medicare guidelines and CMS documentation requirements. Earning a professional coding or billing certification, such as a CPC, strengthens your candidacy and signals regulatory competency to employers.
Can you get hired as a medicare specialist with little experience?
Yes, entry-level medicare specialist roles do exist, particularly in claims processing and enrollment support at larger payers and hospital systems. Employers are more likely to hire candidates with limited experience if they hold a relevant certificate, have completed a medical billing externship, or can demonstrate familiarity with Medicare-specific coding systems and denial reason codes through coursework or self-study.
What does the medicare specialist interview process look like?
Most hiring processes include an initial phone screen focused on your Medicare billing background, followed by one or two interviews with the revenue cycle manager or compliance team. Expect scenario questions about claim denials, appeals procedures, and how you stay current with CMS policy updates. Some employers add a short skills assessment covering coding accuracy or denial resolution logic before making an offer.
Where can I find and apply to medicare specialist jobs?
You can find and apply to medicare specialist jobs on Migrate Mate, which lists current openings from across the United States. Find roles that match your background and apply directly to each listing.
See All 14 Medicare Specialist Jobs
Find roles that match your experience and apply in just a few clicks.
Find Medicare Specialist Jobs