Medical Claims Dispute Resolution Specialist – Troy, 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 disputes and ensuring accurate reimbursement processes.

Job Overview

We are seeking a detail-oriented and analytical professional to support medical claims dispute resolution processes. In this role, you will investigate claim discrepancies, manage disputes, and ensure timely and accurate resolutions.

Key Responsibilities

Investigate and resolve medical insurance claim disputes
Review denied or disputed claims and determine appropriate actions
Verify patient eligibility, coverage, and billing details
Maintain accurate documentation of dispute resolutions
Collaborate with insurance providers and healthcare teams
Ensure compliance with regulatory and policy standards
Track dispute resolution metrics and generate reports
Handle appeals and reprocessing of claims
Identify trends and recommend process improvements
Improve dispute resolution workflows

Required Qualifications

Bachelor’s degree in Healthcare Administration, Finance, or related field
1–3 years of experience in claims processing, dispute 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 dispute 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 dispute resolution, billing, and relevant healthcare or insurance skills.