Insurance Claims Resolution Specialist

Job Summary

To ensure timely and accurate claim resolutions, the remote Insurance Claims Resolution Specialist will manage and resolve outstanding insurance claims, including pending, denied, or incorrectly paid claims, while working Monday through Friday during standard business hours.

Key responsibilities

• Research and resolve outstanding insurance claims by investigating root causes and executing follow-up actions
• Analyze insurance denials to determine validity and complete appropriate resolution steps, such as appeals or resubmissions
• Communicate with insurance carriers to obtain claim status and secure explanations for pending or denied claims

Required qualifications

• High School Diploma or equivalent required
• Strong computer skills, including proficiency in MS Outlook, Word, and Excel
• Proven ability to handle high volume workloads and meet tight deadlines
• Experience in a structured environment with performance metrics is preferred
• Ability to manage work independently in a remote environment