Claims Resolution Specialist Jobs
Claims Resolution Specialist jobs are open across insurance, healthcare, financial services, and third-party administrators, at levels from entry-level associate to senior specialist and team lead, with specializations in medical billing disputes, property and casualty claims, and denial management. Scan the live roles below and apply to whichever ones fit.
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Showing 5 of 12+ Claims Resolution Specialist jobs
Claims Resolution Specialist
(in-office - on-site role)
Starting at $18.50/hr but flexible for experienced candidates
Do you enjoy puzzles and research? Are you results-oriented? If so, our Claims Resolution Specialist position may be a phenomenal career for you within Select Medical! Our dynamic team has the responsibility of resolving outstanding insurance claims so that our patients are not impacted.
We offer an exceptional employee experience, full-time hours, full benefits, paid training, and advancement opportunities. Our team offers flexible, first shift, Monday through Friday schedules. This would include two fifteen-minute breaks and one half-hour lunch. We allow for casual work attire; jeans are our norm!
Responsibilities:
- Investigate and follow-up on all open balances for accounts that have received a payment or denial, or that are greater than 30 days from billing. Contact responsible party to establish reason for non-payment document in system all verbal and written communication relative to open account balance, and institute timely follow-up with responsible party as a result of last contact to assure progress in resolving account with payment.
- Maintain consistent, productive, and timely follow-up, as often as is needed to collect on the account. Time between account follow up is not to exceed 30 days.
- Maintain a productivity of 20 to 25 accounts per day. This is subject to change based on volume changes and operational needs.
- Make outgoing calls to patients, insurance companies and attorneys regarding claim status in order to reduce both outstanding receivables.
- Regularly communicate with hospital staff and department management on any accounts receivable issues/problematic payor trends.
- Identify and resolve issues impacting the timely collection of open receivables.
- As necessary, request account adjustments as identified via write off requests and refund requests.
- Notify database operations of changes or additions to specific payor, plan, contract, address, or other pertinent information as necessary.
- Meet the expectations and goals for productivity and collections targets as set forth by management.
- Performs other duties or special projects as assigned.
Required:
- High School Diploma or Equivalent
- One year of experience within a medical billing, medical collecting or claims processing role.
- Private and commercial claims collection experience (ideally provider side)
- Medicare and Medicaid
- Computer Skills
- Microsoft Office:
- Outlook
- Excel
- Ability to work with multiple programs simultaneously.
- Good interpersonal, oral and written communication skills.
- Previous experience in metrics based role, where production/quality standards are upheld.
- Time management and organizational skills
- Proven experience with investigative research.
- Ability to work independently and as part of team to reach mutually established goals.
- Attention to detail
- Flexibility and being open to change
- This job requires access to confidential and sensitive information, requiring ongoing discretion and secure information management.
- An extensive and thorough paid orientation program.
- Paid Time Off (PTO) and Extended Illness Days (EID).
- Health, Dental, and Vision Insurance; Life insurance; Prescription coverage.
- A 401(k) retirement plan with company match.
- No Required Weekends
- Office Environment
- Sitting for extended periods of time
- Ability to lift weight up to 35 lbs.
Claims Resolution Specialist
(in-office - on-site role)
Starting at $18.50/hr but flexible for experienced candidates
Do you enjoy puzzles and research? Are you results-oriented? If so, our Claims Resolution Specialist position may be a phenomenal career for you within Select Medical! Our dynamic team has the responsibility of resolving outstanding insurance claims so that our patients are not impacted.
We offer an exceptional employee experience, full-time hours, full benefits, paid training, and advancement opportunities. Our team offers flexible, first shift, Monday through Friday schedules. This would include two fifteen-minute breaks and one half-hour lunch. We allow for casual work attire; jeans are our norm!
Responsibilities:
- Investigate and follow-up on all open balances for accounts that have received a payment or denial, or that are greater than 30 days from billing. Contact responsible party to establish reason for non-payment document in system all verbal and written communication relative to open account balance, and institute timely follow-up with responsible party as a result of last contact to assure progress in resolving account with payment.
- Maintain consistent, productive, and timely follow-up, as often as is needed to collect on the account. Time between account follow up is not to exceed 30 days.
- Maintain a productivity of 20 to 25 accounts per day. This is subject to change based on volume changes and operational needs.
- Make outgoing calls to patients, insurance companies and attorneys regarding claim status in order to reduce both outstanding receivables.
- Regularly communicate with hospital staff and department management on any accounts receivable issues/problematic payor trends.
- Identify and resolve issues impacting the timely collection of open receivables.
- As necessary, request account adjustments as identified via write off requests and refund requests.
- Notify database operations of changes or additions to specific payor, plan, contract, address, or other pertinent information as necessary.
- Meet the expectations and goals for productivity and collections targets as set forth by management.
- Performs other duties or special projects as assigned.
Required:
- High School Diploma or Equivalent
- One year of experience within a medical billing, medical collecting or claims processing role.
- Private and commercial claims collection experience (ideally provider side)
- Medicare and Medicaid
- Computer Skills
- Microsoft Office:
- Outlook
- Excel
- Ability to work with multiple programs simultaneously.
- Good interpersonal, oral and written communication skills.
- Previous experience in metrics based role, where production/quality standards are upheld.
- Time management and organizational skills
- Proven experience with investigative research.
- Ability to work independently and as part of team to reach mutually established goals.
- Attention to detail
- Flexibility and being open to change
- This job requires access to confidential and sensitive information, requiring ongoing discretion and secure information management.
- An extensive and thorough paid orientation program.
- Paid Time Off (PTO) and Extended Illness Days (EID).
- Health, Dental, and Vision Insurance; Life insurance; Prescription coverage.
- A 401(k) retirement plan with company match.
- No Required Weekends
- Office Environment
- Sitting for extended periods of time
- Ability to lift weight up to 35 lbs.
Claims Resolution Specialist Jobs by Experience Level
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Find JobsClaims Resolution Specialist Job Market
Who's Hiring
Top Industries Hiring
- Insurance
What Employers Look For
The qualifications that appear most often in claims resolution specialist jobs.
- Two or more years of experience in claims processing, adjusting, or dispute resolution
- Proficiency with claims management software such as Xactimate, Facets, or TriZetto
- Knowledge of insurance policy language, coverage terms, and claims regulations
- Strong written and verbal communication skills for claimant and provider correspondence
- Associate or bachelor's degree in business, health administration, or a related field
- Adjuster license or relevant certification preferred in property and casualty or medical billing roles
Tips for Your Claims Resolution Specialist Job Search
Quantify your resolution outcomes on your resume
Hiring managers want to see what you actually resolved, not just that you handled claims. Include the volume of cases you worked, average turnaround times you met, and any denial overturn rates you improved. Generic duties-based bullets get filtered out fast.
Highlight your claims management software fluency
Many job postings screen for specific platforms like Xactimate, Facets, or TriZetto before a human even reads your resume. Name the systems you've used in a dedicated skills section so applicant tracking systems flag your application as a match.
Apply early to roles that fit
Migrate Mate lists claims resolution specialist openings from across the United States in one place, so you can find roles that match and apply directly to each listing.
Target postings by claims type, not just title
Search for your specific specialty, whether that's workers' compensation, liability, medical billing, or property claims. Employers often prioritize candidates whose experience matches their claims category, so generic applications to mismatched roles rarely move forward.
Prepare for scenario-based interview questions
Interviewers in this field will walk you through a disputed claim scenario and ask how you'd resolve it. Practice explaining your investigation process, how you document decisions, and how you communicate outcomes to claimants and adjusters in clear, defensible terms.
Negotiate using your resolution efficiency data
When it comes time to discuss compensation, cite your measurable impact, like average case closure time or reversal rates, rather than years of experience alone. Employers in claims value demonstrated efficiency, and concrete performance data gives you a stronger basis than tenure.
Claims Resolution Specialist Jobs: Frequently Asked Questions
Which companies are hiring the most claims resolution specialists?
The companies hiring the most claims resolution specialists right now include Sun Life, Liberty Mutual Insurance, and Claritev, with the largest share of openings in Texas, Missouri, and California, based on current listings on Migrate Mate as of July 2026. Insurance carriers, third-party administrators, and large health systems tend to post the most volume consistently.
How many claims resolution specialist jobs are remote?
About 50% of claims resolution specialist openings are fully remote or hybrid as of July 2026, with the highest remote share in medical billing dispute and denial management roles. Property and casualty adjuster positions are more likely to require on-site or field work, especially when physical inspections are part of the job.
How do you become a claims resolution specialist?
Start by building foundational knowledge in insurance, medical billing, or financial services through coursework or an entry-level claims assistant role. Get familiar with claims management software used in your target industry. Pursue relevant certifications such as a state adjuster license or a medical billing credential. Move into resolution-focused roles as you develop experience handling disputes and denials directly.
Can you get hired as a claims resolution specialist with little experience?
Yes, many employers hire candidates with limited direct experience if you can demonstrate transferable skills. Customer service roles that involved dispute resolution, billing, or account corrections are viewed favorably. Employers in healthcare billing are especially open to candidates from medical front-office or coding backgrounds. Emphasize attention to detail, written communication, and any exposure to policy documents or insurance terminology.
What does the claims resolution specialist interview process look like?
Most interviews include an initial phone screen focused on your background in claims or billing, followed by one or two rounds with a hiring manager or team lead. Expect scenario-based questions where you walk through how you'd investigate a disputed claim or communicate a denial decision. Some employers include a short written exercise to assess documentation clarity or policy interpretation.
Where can I find and apply to claims resolution specialist jobs?
You can find and apply to claims resolution specialist jobs on Migrate Mate, which lists current openings from across the United States. Search for roles that match your claims specialty and experience level, then apply directly to each listing that fits.
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