Claims Resolution Specialist

Job Summary

A company is looking for a Claims Resolution Specialist (Customer Service).

Key Responsibilities

• Respond to provider inquiries and research claims payment issues, denials, and contractual agreements
• Participate in a mission-driven culture by providing administrative support and ensuring accurate documentation
• Complete additional duties or projects as assigned

Required Qualifications

• High School diploma or equivalent plus 2 years of experience in claims resolution
• 1 year of call center experience with high call volumes or customer service experience
• 1 year of experience in HMO, Medi-Cal/Medicaid, and healthcare/managed care