Medical Claims Resolution Specialist

Job Summary

Detail-oriented and experienced, the fully remote Medical Claims Resolution Specialist will resolve denied, underpaid, and aging insurance claims, ensuring accurate reimbursement and timely account resolution while managing high claim volumes.

Key responsibilities

• Investigate and resolve denied or underpaid medical claims
• Submit timely appeals and follow up on aging claims through various communication methods
• Collaborate with internal teams to reduce recurring denials and reimbursement delays

Required qualifications

• High school diploma or equivalent required
• 2+ years of experience in medical billing, insurance follow-up, or denial resolution
• Strong understanding of CPT, ICD-10, EOBs, and payer guidelines
• Familiarity with Centricity / Athena EMR preferred
• Experience with surgical or specialty practice billing strongly preferred