Insurance Resolution Specialist

Job Summary

As a fully remote, full-time Insurance Resolution Specialist, the candidate will manage the investigation and resolution of denied insurance claims, utilizing coding knowledge and analytical skills to improve revenue cycle performance.

Key responsibilities

• Analyze and resolve coding and global denials across assigned claims
• Prepare appeals and reconsideration requests supported by relevant claim information
• Communicate with insurance payors to clarify denial reasons and advance resolution

Required qualifications

• High School Graduate or Equivalent
• Two years of relevant experience in insurance denial resolution
• CPC certification preferred
• Knowledge of coding and denial processes
• Experience navigating payor websites and internal systems