Claims Resolution Specialist Jobs in USA with Visa Sponsorship
Claims Resolution Specialists are regularly sponsored for H-1B visa and TN visas when the role requires a bachelor's degree in a business, finance, or healthcare-related field. Employers in insurance, healthcare, and financial services are among the most active sponsors for this position. For detailed occupation requirements, see the O*NET profile.
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The Claims Research & Resolution Representative 2 manages claims operations that involve customer contact, investigation, and resolution of claims or claims-related financial issues. The position includes moderately complex call center, administrative, operational and customer support assignments. Workload is typically semi-routine assignments along with intermediate level math computations. This is an opportunity to work remotely and use your research, resolution and customer service skills to join a Fortune 100 company with a great culture and outstanding benefits. Humana values associate engagement and well-being. We also provide excellent professional development and continued education.
The Claims inbound call center is comprised of a group of calls / claims / provider associates researching the resolution to a pending call. As a Claims Research & Resolution Representative 2, you will work with insurance companies, providers, members, and collection services in the resolution of claims. Your responsibilities include:
- You will take inbound calls to address customer needs which may include complex financial recovery, answering questions, and resolving issues.
- You will potentially be making outbound calls regarding case follow-up.
- You will record notes with details of inquiries, comments or complaints, transactions or interactions and taking action accordingly.
- You will escalate unresolved and pending customer inquiries.
- Decisions you make in this role are typically focused on interpretation of area or department policy and methods for completing assignments.
- Our standard policies and practices allow for some opportunity for interpretation / deviation and / or independent discretion. You will work within defined parameters to identify work expectations and quality standards, but you will have some latitude over prioritization and timing, and will work with minimal direction.
- You will cross-train in all functions within the department.
Use your skills to make an impact
Required Qualifications
- One (1) or more years of Call Center or Telephonic customer service experience (within the past 5 years)
- Previous healthcare related experience or education
- Basic Microsoft Office (Word, Excel, Outlook, and Teams) skills
- You must have strong technical skills with the ability to work across multiple software systems
- You must be self-reliant, with the ability to resolve issues independently under minimum supervision
- You must have the ability to use internal system resources (i.e., Mentor) to find a resolution to an issue and / or respond to an inquiry
- You must have demonstrated time management and prioritization skills
- You must have experience managing multiple or competing priorities
- Requires that you have the capacity to maintain confidentiality while working remotely out of your home
Required Work Schedule
Training
- Virtual training starts on day one of employment and will run up to 8 weeks with a schedule of 8:00 AM to 4:30 PM Eastern Time, Monday - Friday.
- Attendance is vital for your success; no time off will be allowed during training.
- The initial 180 days of employment as a Claims Research & Resolution Representative 2 constitute an appraisal period. This Appraisal Period is essential to your learning and development, which is why we ask for perfect attendance during both the classroom training and nesting periods.
- This position requires learning many systems, policies, and tools, and it takes time to become proficient in the role. You must be willing to remain in this position for a period of twelve (12) months before applying to other Humana opportunities.
Work Hours
- Following training, you must be able to work an assigned 8-hour shift between the hours of 8:00 AM to 6:00 PM Eastern Time.
- Overtime may be offered, based on business needs.
Preferred Qualifications
- Bachelor's Degree
- Prior claims processing experience
- Overpayment experience
- Financial recovery experience
- Previous experience with Mentor software
- PrePay or Post Pay experience
- CAS, CIS or CISPRO experience
- CRM experience
Additional Information
PLEASE MAKE SURE YOU ATTACH YOUR RESUME TO YOUR APPLICATION (PDF OR WORD FORMAT)
Work at Home Requirements: To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
Scheduled Weekly Hours
40
Pay Range
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$40,000 - $52,300 per year
Description of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
Application Deadline: 08-31-2026
About us
About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com.
Equal Opportunity Employer
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Become a part of our caring community
The Claims Research & Resolution Representative 2 manages claims operations that involve customer contact, investigation, and resolution of claims or claims-related financial issues. The position includes moderately complex call center, administrative, operational and customer support assignments. Workload is typically semi-routine assignments along with intermediate level math computations. This is an opportunity to work remotely and use your research, resolution and customer service skills to join a Fortune 100 company with a great culture and outstanding benefits. Humana values associate engagement and well-being. We also provide excellent professional development and continued education.
The Claims inbound call center is comprised of a group of calls / claims / provider associates researching the resolution to a pending call. As a Claims Research & Resolution Representative 2, you will work with insurance companies, providers, members, and collection services in the resolution of claims. Your responsibilities include:
- You will take inbound calls to address customer needs which may include complex financial recovery, answering questions, and resolving issues.
- You will potentially be making outbound calls regarding case follow-up.
- You will record notes with details of inquiries, comments or complaints, transactions or interactions and taking action accordingly.
- You will escalate unresolved and pending customer inquiries.
- Decisions you make in this role are typically focused on interpretation of area or department policy and methods for completing assignments.
- Our standard policies and practices allow for some opportunity for interpretation / deviation and / or independent discretion. You will work within defined parameters to identify work expectations and quality standards, but you will have some latitude over prioritization and timing, and will work with minimal direction.
- You will cross-train in all functions within the department.
Use your skills to make an impact
Required Qualifications
- One (1) or more years of Call Center or Telephonic customer service experience (within the past 5 years)
- Previous healthcare related experience or education
- Basic Microsoft Office (Word, Excel, Outlook, and Teams) skills
- You must have strong technical skills with the ability to work across multiple software systems
- You must be self-reliant, with the ability to resolve issues independently under minimum supervision
- You must have the ability to use internal system resources (i.e., Mentor) to find a resolution to an issue and / or respond to an inquiry
- You must have demonstrated time management and prioritization skills
- You must have experience managing multiple or competing priorities
- Requires that you have the capacity to maintain confidentiality while working remotely out of your home
Required Work Schedule
Training
- Virtual training starts on day one of employment and will run up to 8 weeks with a schedule of 8:00 AM to 4:30 PM Eastern Time, Monday - Friday.
- Attendance is vital for your success; no time off will be allowed during training.
- The initial 180 days of employment as a Claims Research & Resolution Representative 2 constitute an appraisal period. This Appraisal Period is essential to your learning and development, which is why we ask for perfect attendance during both the classroom training and nesting periods.
- This position requires learning many systems, policies, and tools, and it takes time to become proficient in the role. You must be willing to remain in this position for a period of twelve (12) months before applying to other Humana opportunities.
Work Hours
- Following training, you must be able to work an assigned 8-hour shift between the hours of 8:00 AM to 6:00 PM Eastern Time.
- Overtime may be offered, based on business needs.
Preferred Qualifications
- Bachelor's Degree
- Prior claims processing experience
- Overpayment experience
- Financial recovery experience
- Previous experience with Mentor software
- PrePay or Post Pay experience
- CAS, CIS or CISPRO experience
- CRM experience
Additional Information
PLEASE MAKE SURE YOU ATTACH YOUR RESUME TO YOUR APPLICATION (PDF OR WORD FORMAT)
Work at Home Requirements: To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
Scheduled Weekly Hours
40
Pay Range
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$40,000 - $52,300 per year
Description of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
Application Deadline: 08-31-2026
About us
About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com.
Equal Opportunity Employer
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
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Get Access To All JobsTips for Finding Visa Sponsorship as a Claims Resolution Specialist
Target industries with established sponsorship track records
Insurance carriers, managed care organizations, and large hospital systems file the most H-1B petitions for Claims Resolution Specialists. Focusing your search on these sectors significantly improves your odds of finding an employer willing to sponsor.
Confirm your degree field supports a specialty occupation argument
USCIS requires a direct connection between your degree field and the role. Degrees in health information management, finance, business administration, or a related discipline strengthen the specialty occupation case for claims-focused positions.
Ask about sponsorship before the final interview stage
Raise the sponsorship question early, ideally after a recruiter confirms genuine interest. Waiting until an offer is extended wastes both sides' time if the employer has a firm no-sponsorship policy for this role.
Highlight systems and regulatory knowledge in your application
Employers justify sponsorship by demonstrating specialized need. Proficiency in claims management platforms, knowledge of payer contracts, or experience with denial management workflows makes the specialty occupation argument considerably easier to support.
Understand that TN visa eligibility depends on your specific duties
Canadian and Mexican nationals may qualify under TN if the role aligns with an eligible occupation such as accountant or management consultant. The job duties, not just the title, determine whether TN classification applies.
Browse verified sponsoring employers on Migrate Mate
Not every employer advertising a Claims Resolution Specialist role will sponsor. Migrate Mate filters for employers with active sponsorship history, saving you from applying to positions where visa support is unlikely from the outset.
Frequently Asked Questions
Can a Claims Resolution Specialist role qualify as a specialty occupation for H-1B purposes?
Yes, but it requires careful documentation. USCIS looks for a direct relationship between the job duties and a specific bachelor's degree field. Roles involving complex payer contract interpretation, regulatory compliance, or denial analysis in healthcare or insurance are the strongest candidates. Generic claims processing positions with no degree requirement typically do not qualify.
Which visa types are most commonly used to sponsor Claims Resolution Specialists?
The H-1B visa is the most common path. Canadian nationals may qualify under the TN visa if their duties map to an eligible USMCA occupation and their degree supports that classification. Australians with relevant qualifications may qualify for the E-3 visa. The right visa depends on your nationality, degree field, and the specific responsibilities of the role.
What degree do I need to get sponsored as a Claims Resolution Specialist?
Most employers filing H-1B petitions for this role require a bachelor's degree in health information management, business administration, finance, healthcare administration, or a closely related field. A general business degree can work if your coursework or experience is demonstrably relevant to claims operations and denial resolution.
How do I find Claims Resolution Specialist jobs where employers are open to sponsorship?
Most job postings don't state sponsorship willingness upfront, which makes filtering difficult. Migrate Mate surfaces roles from employers with verified sponsorship histories, so you can focus your applications on companies that have demonstrated a willingness to file petitions for positions like this one.
Are H-1B approvals common for this job title, and what affects approval odds?
Approval rates for claims-related roles vary considerably. Petitions that clearly document why the position requires a specific degree field, and where the offered duties go beyond routine processing, tend to perform better. Employers with prior approvals for similar roles and those working with experienced immigration counsel also see stronger outcomes. The H-1B lottery remains the primary obstacle regardless of petition quality.
What is the prevailing wage requirement for sponsored Claims Resolution Specialist jobs?
U.S. employers sponsoring a visa must pay at least the prevailing wage, which is what workers in the same role, area, and experience level typically earn. The Department of Labor sets this rate to make sure companies aren't hiring foreign workers simply because they'd accept lower pay than a U.S. worker. It varies by job title, location, and experience. You can look up current prevailing wage rates for any occupation and location using the OFLC Wage Search page.