Claims & Benefits Resolution Specialist
5 days ago
Job Title : Claims & Benefits Resolution Specialist Pay Rate : $25.00-$26.00
Training Onsite; Remote After Training with 1 Required Onsite Day/Month)
Department: Revenue Cycle Management – Central Business Office
Minimum 2–3 years of experience in healthcare revenue cycle, claims processing, eligibility/benefits, or authorizations.
Strong understanding of payer rules, reimbursement methodologies, and claims adjudication.
Familiarity with Epic, payer portals, and other claims/RCM systems.
Experience resolving complex claim issues across multiple systems.
Ability to work independently, troubleshoot problems, and drive claims to completion
Experience working in a Central Business Office or Shared Services model.
Prior experience supporting Utah-based payer populations or multi-state payer networks.
Our client is seeking a Claims & Benefits Resolution Specialist for a contract opportunity. This role performs comprehensive audits and resolution activities across the claims lifecycle, ensuring accurate billing, timely reimbursement, and compliance with payer requirements. The specialist will handle complex claim discrepancies, conduct follow-up with payers, and coordinate with clinical and non-clinical teams to finalize claim determinations. The ideal candidate has strong revenue cycle experience, particularly in claims, eligibility, benefits, and authorizations, and can quickly identify root-cause errors in a high-volume environment.
This is an operational “fix-it” position — the manager needs someone who doesn’t just process claims but can find what’s broken and correct it without hand-holding.
Claims Audit & Correction
Perform comprehensive audits on assigned accounts to identify billing, payment, and adjustment errors.
Correct claim discrepancies within established turnaround times.
Ensure claim data accuracy, compliant coding, and alignment with the member’s plan benefit.
Timely & Accurate Claims Processing
Process claims quickly and accurately according to organizational benchmarks.
Apply reimbursement rules based on the member’s benefits and plan specifications.
Conduct follow-up on delayed, denied, or pended claims; Investigate processing delays, missing information, or system errors and implement corrective action.
Refer cases to clinical management teams when medical review is required to ensure appropriate reimbursement.
Verify and document member eligibility, benefits coverage, and authorization requirements.
Work closely with leadership, clinical review staff, and the CBO team to ensure timely resolution of claim issues.
Participate in problem-solving discussions related to claim trends or systemic issues.
Support training and onboarding efforts as needed during onsite sessions.
Minimum 2–3 years of experience in healthcare revenue cycle, claims processing, eligibility/benefits, or authorizations.
Strong understanding of payer rules, reimbursement methodologies, and claims adjudication.
Familiarity with Epic, payer portals, and other claims/RCM systems.
Experience resolving complex claim issues across multiple systems.
Ability to work independently, troubleshoot problems, and drive claims to completion
Experience working in a Central Business Office or Shared Services model.
Prior experience supporting Utah-based payer populations or multi-state payer networks.
-
West Valley, UT, United States Kavaliro Full timeJob Title : Claims & Benefits Resolution Specialist Pay Rate : $25.00-$26.00 Start Date : 12-22-2025 Location : West Valley City, UT 84120(Training Onsite; Remote After Training with 1 Required Onsite Day/Month) Department: Revenue Cycle Management Central Business Office Assignment Length : 3 Months (Potential Extension) Top Things Needed: Minimum 23 years...
-
Claims & Benefits Resolution Specialist
4 days ago
West Valley City, United States Kavaliro Full timeJob Title: Claims & Benefits Resolution SpecialistPay Rate: $25.00-$26.00Start Date: 12-22-2025Location: West Valley City, UT 84120(Training Onsite; Remote After Training with 1 Required Onsite Day/Month) Department: Revenue Cycle Management – Central Business Office Assignment Length: 3 Months (Potential Extension) Top Things Needed: Minimum 2–3 years...
-
Claims & Benefits Resolution Specialist
20 hours ago
West Valley City, United States Kavaliro Full timeJob Title: Claims & Benefits Resolution SpecialistPay Rate: $25.00-$26.00Start Date: 12-22-2025Location: West Valley City, UT 84120(Training Onsite; Remote After Training with 1 Required Onsite Day/Month) Department: Revenue Cycle Management – Central Business Office Assignment Length: 3 Months (Potential Extension) Top Things Needed: Minimum 2–3 years...
-
Claims & Benefits Resolution Specialist
12 hours ago
West Valley City, United States Kavaliro Full timeJob Title: Claims & Benefits Resolution SpecialistPay Rate: $25.00-$26.00Start Date: 12-22-2025Location: West Valley City, UT 84120(Training Onsite; Remote After Training with 1 Required Onsite Day/Month) Department: Revenue Cycle Management – Central Business Office Assignment Length: 3 Months (Potential Extension) Top Things Needed: Minimum 2–3 years...
-
Claims & Benefits Resolution Specialist
18 hours ago
West Valley City, United States Kavaliro Full timeClaims & Benefits Resolution SpecialistOur client is seeking a Claims & Benefits Resolution Specialist for a contract opportunity. This role performs comprehensive audits and resolution activities across the claims lifecycle, ensuring accurate billing, timely reimbursement, and compliance with payer requirements. The specialist will handle complex claim...
-
West Valley City, United States Kavaliro Full timeJob Title: Claims & Benefits Resolution SpecialistPay Rate: $25.00-$26.00Start Date: 12-22-2025Location: West Valley City, UT 84120(Training Onsite; Remote After Training with 1 Required Onsite Day/Month) Department: Revenue Cycle Management Central Business Office Assignment Length: 3 Months (Potential Extension) Top Things Needed: Minimum 23 years of...
-
Medical Claims Consultant
4 days ago
West Valley, UT, United States Insight Global Full timeJob Title: Claims & Benefits Resolution Specialist Location : West Valley City, UT Department : Revenue Cycle Management – Central Business Office Assignment Length: 3 Months (Potential Extension) Position Summary: This role performs comprehensive audits and resolution activities across the claims lifecycle, ensuring accurate billing, timely...
-
Medical Claim Processor
3 days ago
West Valley, UT, United States Insight Global Full timeJob Title: Claims & Benefits Resolution Specialist Location : West Valley City, UT Department : Revenue Cycle Management Central Business Office Assignment Length: 3 Months (Potential Extension) Position Summary: This role performs comprehensive audits and resolution activities across the claims lifecycle, ensuring accurate billing, timely...
-
Medical Claims Processor
12 hours ago
West Valley City, United States Insight Global Full timeJob Title: Claims & Benefits Resolution SpecialistLocation: West Valley City, UTDepartment: Revenue Cycle Management – Central Business OfficeAssignment Length: 3 Months (Potential Extension)Position Summary: This role performs comprehensive audits and resolution activities across the claims lifecycle, ensuring accurate billing, timely reimbursement, and...
-
Medical Claims Processor
2 days ago
West Valley City, United States Insight Global Full timeJob Title: Claims & Benefits Resolution SpecialistLocation: West Valley City, UTDepartment: Revenue Cycle Management – Central Business OfficeAssignment Length: 3 Months (Potential Extension)Position Summary: This role performs comprehensive audits and resolution activities across the claims lifecycle, ensuring accurate billing, timely reimbursement, and...
