Medical Claims Resolution Analyst – Sterling Heights, 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 and managing medical insurance claims efficiently.
Job Overview
We are seeking a detail-oriented and analytical professional to handle medical claims resolution processes. In this role, you will investigate claim issues, ensure accurate processing, and support timely reimbursement.
Key Responsibilities
Review and resolve medical insurance claim discrepancies
Investigate denied or pending claims and take corrective actions
Verify patient eligibility and coverage details
Maintain accurate documentation of claim resolutions
Collaborate with insurance providers and healthcare teams
Ensure compliance with regulatory and policy standards
Track claim resolution metrics and generate reports
Handle appeals and reprocessing of claims
Identify trends and recommend process improvements
Improve claims resolution workflows
Required Qualifications
Bachelor’s degree in Healthcare Administration, Finance, or related field
1–3 years of experience in claims processing, resolution, or healthcare billing roles
Basic understanding of medical coding and billing (ICD, CPT)
Strong analytical and attention-to-detail skills
Good communication and problem-solving abilities
Ability to work with claims management systems
Preferred Qualifications
Experience in insurance companies or healthcare billing departments
Familiarity with claims adjudication systems
Knowledge of healthcare regulations and compliance
Understanding of reimbursement policies and payer systems
Certification in medical billing or coding (preferred)
Why Join Us?
Work with a leading U.S.-based healthcare organization
Gain hands-on experience in claims resolution and insurance processes
Supportive and collaborative work environment
Competitive salary and benefits
Opportunities for career growth in healthcare finance and administration
How to Apply
Submit an ATS-friendly resume highlighting your experience in claims resolution, billing, and relevant healthcare or insurance skills.
