Healthcare Account Associate

Job overview

The Healthcare Account Associate role is onsite in Bethesda, MD, with compensation of $90,000 per year. MedVanta describes itself as a physician-owned musculoskeletal platform that combines technology, clinical expertise, data-driven insights, and care navigation to support musculoskeletal health. The associate reviews and processes stop-loss claims, evaluates claim documentation and policy compliance, and supports client relationships and reporting. The work helps ensure accurate claim decisions, identify potential discrepancies, control losses, and provide clients with clear information and service.

What you'll do

• Process incoming and aggregated stop-loss claims
• evaluate claims submitted by TPAs and PBMs for policy, regulatory, and industry compliance
• review complex potential claims and audit for eligibility, duplicate charges, and completeness
• determine whether to pend or adjudicate claims and finalize claims within the assigned threshold
• prepare pended-claim letters
• identify discrepancies and refer cases to the Special Investigation Unit as needed
• support client performance evaluations and client service programs
• maintain claim records and system accuracy
• create benefit and aggregator reports.

What we're looking for

Skills & competencies

healthcare account associate

bethesda md

medvanta

full-time

$90,000/year

stop-loss claims

health insurance claims

claims processing

compliance review

client relations

medical terminology

power bi

excel

Work arrangement

• Weekend coverage required

Why this role

Requires a high school diploma or GED, five years of relevant health insurance claims experience, three years processing first-dollar health insurance claims, and three years of medical terminology experience. Stop-loss claims analysis and WEX experience are preferred.

About the employer

MedVanta Interco, LLC. is hiring for this role. Industry: Direct Health and Medical Insurance Carriers. Sector: 52.