Claims Resolution Specialist

Job Summary

A company is looking for a Claims Resolution Representative to join their team.

Key Responsibilities

• Independently resolve suspended claims and process recoupments according to operational procedures
• Review and analyze claims, ensuring accuracy and compliance with policies and reimbursement rules
• Facilitate manual entry of claims and address discrepancies in charges and payments

Required Qualifications

• High School Diploma or GED
• 1+ years of experience in the healthcare field focused on issue resolution
• Ability to navigate multiple computer claims and eligibility platforms
• Strong computer skills, including proficiency in MS Word and Excel
• Self-directed with the ability to work independently and collaboratively