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 while collaborating with insurance payers and internal teams to ensure accurate reimbursement and timely account resolution.

Key responsibilities

• Investigate and resolve denied or underpaid medical claims
• Submit timely and accurate appeals based on payer-specific guidelines
• Collaborate with internal billing, coding, and operational teams to reduce recurring denials

Required qualifications

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