Medical Claims Resolution Specialist – Warren, Michigan

Job Description

About the Company

Skill Gigs is a global IT and healthcare consulting firm that connects skilled professionals with leading organizations worldwide. This opportunity is with one of our U.S.-based healthcare partners, focused on resolving medical claims issues and ensuring accurate billing processes.

Job Title

Medical Claims Resolution Specialist

Location

Warren

Job Overview

We are seeking a detail-oriented and analytical Medical Claims Resolution Specialist to manage and resolve healthcare claims issues. In this role, you will investigate discrepancies, coordinate with payers, and ensure timely claim resolution.

Key Responsibilities

Review and resolve denied or disputed medical claims
Investigate billing discrepancies and identify root causes
Coordinate with insurance providers and healthcare teams
Maintain accurate records of claim resolutions
Ensure compliance with healthcare billing regulations
Analyze claim data and generate reports
Support quality assurance and process improvements
Communicate with patients and providers regarding claims
Track resolution metrics and performance indicators
Improve claims resolution workflows

Required Qualifications

Bachelor’s degree in Healthcare Administration, Finance, or related field
1–3 years of experience in medical billing, claims processing, or resolution roles
Strong knowledge of healthcare billing and insurance processes
Basic understanding of coding standards (ICD, CPT)
Good analytical and problem-solving skills
Strong attention to detail and organizational abilities
Effective communication and coordination skills

Preferred Qualifications

Experience in healthcare claims resolution or revenue cycle roles
Familiarity with billing software and EHR systems
Knowledge of payer requirements and reimbursement processes
Certification such as CPC, CCS, or similar (preferred)
Understanding of denial management and appeals processes

Why Join Us?

Work with a leading U.S.-based healthcare organization
Gain hands-on experience in medical claims resolution and revenue cycle
Supportive and collaborative work environment
Competitive salary and benefits
Opportunities for career growth in healthcare finance and operations

How to Apply

Submit an ATS-friendly resume highlighting your experience in medical claims resolution, billing processes, and relevant healthcare systems.