<p>We are seeking a detail-oriented <strong>Medical Claims Resolution Specialist</strong> to support the timely review, research, and resolution of medical claims issues. This role is responsible for investigating denied, rejected, or unpaid claims, working with payers and internal teams, and ensuring accurate claim processing and reimbursement.</p><p><br></p><p><strong>Hours:</strong> Monday - Friday 8am - 5pm *after hours</p><p><br></p><p>Responsibilities:</p><ul><li>Review and analyze denied, rejected, or outstanding medical claims to identify root causes</li><li>Research claim discrepancies, billing issues, coding errors, and payer requirements</li><li>Communicate with insurance companies, patients, and internal departments to resolve claim issues efficiently</li><li>Submit corrected claims, appeals, and supporting documentation as needed</li><li>Track claim status and maintain accurate documentation of follow-up actions and resolutions</li><li>Ensure compliance with payer guidelines, HIPAA, and company policies</li><li>Collaborate with billing, coding, and revenue cycle teams to improve claim resolution processes</li><li>Identify trends in denials and recommend process improvements</li></ul><p><br></p>