Medical Claims Resolution Analyst – Dearborn Heights, Michigan
Job Description
About the Company
SkillGigs is an advanced talent marketplace connecting skilled healthcare and technology professionals with leading organizations across the United States. This opportunity is with one of our trusted U.S.-based healthcare partners, focused on medical claims processing, healthcare compliance, and patient financial services.
Job Overview
We are seeking a detail-oriented and analytical professional to support medical claims resolution operations. In this role, you will review insurance claims, investigate billing discrepancies, resolve denied or pending claims, and ensure compliance with healthcare reimbursement policies to support accurate and timely claims processing.
Key Responsibilities
Review and analyze medical claims for accuracy, completeness, and compliance
Investigate denied, delayed, or disputed claims and coordinate resolutions
Communicate with insurance providers, healthcare teams, and billing departments
Process claims corrections, appeals, and reimbursement adjustments
Maintain accurate documentation of claims activities and case outcomes
Monitor claims trends and identify recurring issues or risks
Ensure adherence to HIPAA, CMS, and payer-specific regulations
Generate claims resolution reports and performance metrics
Support process improvements for billing and reimbursement workflows
Strengthen overall claims efficiency and patient financial service quality
Required Qualifications
Bachelor’s degree in Healthcare Administration, Business Administration, Finance, or related field
1–3 years of experience in medical billing, claims processing, healthcare reimbursement, or insurance operations
Basic understanding of medical coding, claims adjudication, and insurance policies
Familiarity with healthcare billing systems and reimbursement workflows
Strong analytical, organizational, and communication skills
Detail-oriented with strong problem-solving capabilities
Preferred Qualifications
Experience with claims management systems, EHR/EMR platforms, or billing software
Knowledge of ICD-10, CPT, HCPCS, and payer regulations
Familiarity with Medicare, Medicaid, and commercial insurance claims processes
Understanding of healthcare compliance and revenue cycle management
Relevant certifications such as CPC, CPB, or medical billing credentials
Why Join Us?
Work with a leading U.S.-based healthcare organization through SkillGigs
Gain valuable experience in healthcare claims resolution and financial services
Supportive and collaborative work environment
Competitive salary and benefits
Excellent opportunities for career advancement in healthcare administration, billing, and compliance
How to Apply
Submit an ATS-friendly resume highlighting your experience in medical claims processing, billing systems, healthcare reimbursement, compliance standards, and relevant certifications.