Resolution Specialist

Job Description

Company Overview
Our client is a leading healthcare services organization dedicated to helping providers navigate complex reimbursement processes and improve financial outcomes. By leveraging deep industry expertise and a commitment to accuracy, they partner with healthcare systems to ensure claims are managed efficiently and thoroughly. Their team-focused environment emphasizes collaboration, accountability, and delivering measurable results for their clients.


Role Summary
The Insurance Follow-Up Specialist plays a critical role in supporting the revenue cycle process by ensuring timely and accurate follow-up on insurance claims and appeals. This position directly contributes to maximizing reimbursement outcomes for healthcare providers.


In this role, you will work closely with appeals specialists and internal teams to track claim status, resolve issues, and provide detailed updates. You will engage with insurance carriers, utilize payer portals, and maintain accurate documentation to ensure progress across accounts while identifying opportunities for process improvement.


Key Responsibilities
• Contact insurance carriers to follow up on claim and appeal status, ensuring timely movement through the claims process
• Review payer portals and client systems to verify claim status and gather relevant updates
• Document all interactions and findings accurately in internal systems
• Collaborate with appeals specialists to support reimbursement efforts and resolve outstanding issues
• Identify and escalate claim discrepancies or submission errors as needed
• Assist with special projects and initiatives to support client needs
• Maintain a high level of organization and attention to detail across multiple accounts


Key Requirements
• 1 to 3 years of experience in insurance follow up or healthcare revenue cycle preferred
• High School Diploma or GED required, Bachelor's degree preferred
• Strong knowledge of healthcare insurance processes, claims, and appeals
• Experience troubleshooting and resolving claim submission errors
• Familiarity with payer portals and healthcare systems
• Demonstrated attention to detail and ability to manage multiple priorities
• Excellent written and verbal communication skills
• Team oriented with strong problem solving skills and adaptability
• Previous work from home experience preferred