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US

  • Responsible for initiating ERA and EFT setup with clearinghouses and payers.
  • Assist in vendor support for daily cash reconciliation and understand RCM Payment Posting Processing.
  • Maintain payer portal admin and employee registration; resolve unidentified payments.

Medical Billing EHR Medical Terminology

19 jobs similar to Claims Resolution Specialist

Jobs ranked by similarity.

US

  • Manage insurance account workflows and ensure accurate resolution of billing and reimbursement issues.
  • Investigate, resolve, and appeal insurance denials while documenting actions in compliance with standards.
  • Monitor aged accounts receivable and prioritize workloads to optimize collections and reduce outstanding balances.

Our partner is a healthcare services organization focused on revenue cycle management. They offer a collaborative and mission-driven environment with a comprehensive benefits package.

United States

  • Ensures accuracy and timeliness of patient financial records, including payment posting, insurance follow-up, and revenue integrity.
  • Monitors work queues, resolves payer discrepancies, and supports provider enrollment and revalidation activities.
  • Assists with charge review and correction using Epic workflows to improve reimbursement accuracy and cash flow.

This position is listed on behalf of a partner company that manages all applications and next steps for a healthcare revenue cycle environment. The role supports multiple Patient Financial Services functions within a large, process-driven healthcare organization.

US Unlimited PTO

  • Process timely and accurate billing of medical claims in multiple states.
  • Monitor accounts daily to maximize reimbursement and identify potential billing compliance issues.
  • Utilize EHR and billing systems to manage claims, denials, and payer communications.

Indigenous Pact PBC, Inc. is a certified B-Corporation established in 2017 with a mission to create health equity for American Indians and Alaskan Natives. The dedicated team has decades of experience working in Indian Country, specializing in customized solutions for sustainable revenue and improved health outcomes.

US

  • Investigate and resolve denied, underpaid, or aging insurance claims using payer portals and billing systems.
  • Submit timely appeals and manage aging reports to reduce revenue delays.
  • Collaborate with billing, coding, and operational teams to resolve claim issues and maintain accuracy.

Metro Vein Centers is a rapidly growing healthcare practice specializing in state-of-the-art vein treatments. With over 70 clinics across 8 states and a Net Promoter Score of 93, we deliver compassionate, results-driven care in a modern, patient-first environment.

US

  • Ensures optimum reimbursement and improves day-to-day operations of the revenue cycle.
  • Processes and follows up on payer issues with various entities for completion.
  • Researches and resolves straightforward account activity and maintains accuracy of the revenue cycle system.

Athletico empowers people, inspires hope and transforms lives through exceptional, progressive fitness, performance and rehabilitative services. They are a people-focused company with a strong culture built on core values like one team, recognition, and trust and integrity.

US

  • Maintains practice management systems, processes insurance claims, and reconciles patient accounts.
  • Investigates rejected claims, corrects denials, and facilitates payment through collections and billing reminders.
  • Ensures HIPAA compliance, resolves patient billing issues, and provides professional customer service.

US Anesthesia Partners provides anesthesia services and revenue cycle management. It is a large US-based healthcare organization focused on billing and insurance operations, emphasizing accuracy and compliance.

United States 2w PTO

  • Review and analyze insurance denials using EOBs, payer correspondence, and claims data to determine appropriate resolution strategies.
  • Differentiate between clinical and technical denials and identify required next steps for appeals or reprocessing.
  • Prepare and submit appeals using supporting documentation such as medical records, appeal letters, and clinical justification when necessary.

Jobgether is an AI-powered job matching platform that connects candidates with hiring companies. They use automated technology to review applications and share top-fitting candidates directly with employers, ensuring a fair and efficient hiring process.

US 4w PTO

  • Own the full AR cycle: payment posting, cash reconciliation, aging management, and payer follow-up across district, health plan, and member inquiries.
  • Investigate and resolve complex claim denials and rejections, submit corrected claims and appeals, and drive systemic fixes to improve clean claim rates.
  • Serve as internal subject matter expert on payer requirements, billing regulations, and compliance standards, fielding escalations from clinical and operations teams.

Cartwheel is building a new kind of mental health program for kids that puts schools at the center. Backed by top investors, it has grown to serve more than fifty school districts across six states and is driven by a mission to help millions of students experience joy.

US

  • Prepare, review, and submit Medicare Part A & B claims for skilled nursing residents.
  • Ensure timely and accurate billing in accordance with CMS and SNF-specific guidelines.
  • Track, appeal, and resolve denied or rejected claims efficiently.

Tutera Senior Living & Health Care is dedicated to providing senior living and healthcare services guided by the YOUNITE philosophy. The company is family-owned, founded in 1985, and offers stability, competitive wages, and benefits, with a focus on developing employees through Tutera University.

Global

  • Investigate and resolve health plan denials for coding-related issues, including rejections, down codes, bundling, modifiers, and level of service.
  • Generate appeals based on dispute reasons and contract terms specific to payors, including online reconsiderations and following payer guidelines.
  • Maintain working knowledge of workflows, systems, and tools used in the department, adhering to production and quality standards.

Ventra is a leading business solutions provider for facility-based physicians, focusing on Revenue Cycle Management. The company partners with private practices, hospitals, health systems, and ambulatory surgery centers to deliver data-driven solutions.

US

  • Contact patients for payments on outstanding balances.
  • Process account adjustments and establish payment plans.
  • Maintain confidentiality and adhere to HIPAA regulations.

AnewHealth is a leading pharmacy care management company specializing in complex, chronic needs care. With over 1,400 team members, they care for more than 100,000 people across all 50 states.

US 12w maternity 12w paternity

  • Generate routine customer invoices accurately and on time according to contractual terms and billing schedules.
  • Apply customer payments, perform collections follow-up, and reconcile client accounts.
  • Collaborate with internal teams to resolve billing issues and support process improvements.

Included Health is a healthcare company that delivers integrated virtual care and navigation services to raise the standard of healthcare for everyone. Though specific employee count is not mentioned, the company fosters a remote-first culture and offers comprehensive benefits.

US

  • Ensure accurate and timely billing and reimbursement by submitting clean claims to primary and secondary payers
  • Review, correct, and resubmit rejected or denied claims, track accounts receivable, and maintain detailed AR status reporting
  • Communicate regularly with insurance companies, providers, and internal teams to resolve billing issues and verify insurance eligibility

LUX Infusion reimagines infusion care to be more human, supportive, and connected, guiding patients through complex therapies. As a clinician-led U.S. organization, they foster an inclusive culture where every team member feels valued and empowered.

US

  • Manage and resolve high volumes of patient accounts for services provided by Essentia Health.
  • Serve as primary contact for patients to discuss statements, resolve inquiries, and provide financial assistance via phone and face-to-face.
  • Perform account analysis, follow up on delinquent accounts, and handle payment plans and collections.

Essentia Health is a healthcare system providing patient- and family-centered care in communities across the upper Midwest. It is a large organization that values quality, hospitality, respect, joy, justice, stewardship, and teamwork.

US

  • Provide empathetic, patient-centered support for billing and insurance questions.
  • Explain insurance concepts like deductibles, copays, and coinsurance to patients.
  • Act as a liaison between patients, providers, and internal teams to ensure a seamless experience.

Allara is a comprehensive women's health provider that specializes in expert, longitudinal care for hormonal, metabolic, and reproductive health. Trusted by over 60,000 women nationwide, Allara is one of the fastest-growing women's health platforms in the U.S.

US 4w PTO

  • Improve first-pass claim acceptance by ensuring correct coding, flagging inconsistencies, and reviewing EOBs and denial trends to identify recurring issues.
  • Work closely with billing teams and vendors to resolve complex claim issues, review clinical documentation, and support coding corrections and resubmissions.
  • Ensure compliance with CMS, state Medicaid, and managed-care guidelines while monitoring payer policy changes to optimize coding and billing practices.

ReKlame Health is a clinician-led, tech-enabled provider group providing culturally competent behavioral health and addiction care. As an early-stage organization focused on expanding access to care and health equity, they are building a purpose-driven team dedicated to making a positive impact.

US

  • Facilitate client calls related to contracting and payer enrollments.
  • Run and analyze client KPIs, providing regular reports.
  • Manage the full contracting and payer enrollment process.

Experity transforms on-demand healthcare across the U.S. by empowering urgent care clinics with industry-leading software. The company fosters a team-first culture with opportunities for flexible work and career development.

US

  • Manage all aspects of payer enrollment for independent providers and care centers in the New Jersey market.
  • Investigate claims/enrollment issues, work within AthenaOne EMR, and resolve Salesforce cases.
  • Partner with internal teams including National Credentialing, Implementation, and Operations Consultants.

Privia Health is a technology-driven national physician enablement company that collaborates with medical groups, health plans, and health systems to optimize physician practices and improve patient experiences. The company is led by top industry talent and focuses on reducing healthcare costs through scalable operations and cloud-based technology, with a culture that values diversity and inclusion.

US

  • Answering live calls, chats, and emails from clinicians and clients.
  • Collaborating with internal teams to resolve roadblocks.
  • Working with RCM and Engineering to address bugs and billing issues.

Grow Therapy is a three-sided marketplace that empowers therapists, patients, and insurance payors through technology. With over $328M in funding and a $3B valuation, they have empowered thousands of therapists and hundreds of thousands of clients.