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Allstate Claims Resolution Specialist Jobs (NOW HIRING)

Caduceus Inc

Claims Resolution Specialist

Jersey City, NJ · On-site

$21 - $23/hr

Demonstrate competency as a claims resolution specialist for a large-scale multi-specialty/multi-site healthcare organizations in the U.S. * Perform claims resolution or medical billing and appeals ...

Select Medical

Claims Resolution Specialist

Camp Hill, PA · On-site

$18.50/hr

Overview Claims Resolution Specialist (in-office - on-site role) Starting at $18.50/hr but flexible for experienced candidates Do you enjoy puzzles and research? Are you results-oriented? If so, our ...

VieMed

Claims Resolution Specialist

Lafayette, LA · On-site

$14 - $18.50/hr

Claims generation * Establishes and maintains effective communication and good working relationships with insurance carriers, patients/family, and other internal teams for the patient's benefit.

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Allstate Claims Resolution Specialist information

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How much do allstate claims resolution specialist jobs pay per hour?

As of Aug 17, 2026, the average hourly pay for allstate claims resolution specialist in the United States is $23.50, according to ZipRecruiter salary data. Most workers in this role earn between $17.55 and $25.72 per hour, depending on experience, location, and employer.

What does an Allstate claims resolution specialist do?

An Allstate Claims Resolution Specialist is responsible for handling insurance claims from start to finish. They review claim details, investigate circumstances, communicate with customers and involved parties, and determine the extent of Allstate's liability. Their goal is to resolve claims efficiently and fairly, ensuring compliance with company policies and state regulations. They may also negotiate settlements and coordinate repairs or payments, providing support and guidance to policyholders throughout the process.

How does an Allstate claims resolution specialist typically collaborate with other departments during the claims process?

As a Claims Resolution Specialist at Allstate, you will frequently collaborate with various departments such as underwriting, legal, and customer service to efficiently resolve claims. This cross-functional teamwork ensures that all aspects of a claim are accurately evaluated and handled in compliance with company policies and state regulations. Regular communication with adjusters, policyholders, and sometimes external vendors is also a key part of the workflow. Building strong relationships with colleagues across teams can help streamline processes and improve customer satisfaction.

What are the key skills and qualifications needed to thrive as an Allstate claims resolution specialist, and why are they important?

To thrive as an Allstate Claims Resolution Specialist, you need a solid understanding of insurance policies, claims processing, and investigative techniques, typically supported by a relevant degree or prior experience in insurance or customer service. Familiarity with claims management systems, document processing software, and sometimes state adjuster licensing is essential. Strong attention to detail, problem-solving abilities, and effective communication skills set top performers apart in this role. These competencies are crucial for accurately resolving claims, ensuring customer satisfaction, and maintaining compliance with regulatory standards.

What is the difference between Allstate Claims Resolution Specialist vs Allstate Claims Adjuster?

AspectAllstate Claims Resolution SpecialistAllstate Claims Adjuster
Required CredentialsHigh school diploma or equivalent; some roles may require licensing or certificationsHigh school diploma; state licensing often required
Work EnvironmentOffice-based, customer service-focused, often in call centers or claims officesField and office-based; inspecting damages and interviewing claimants
Employer & Industry UsageInsurance companies, customer service centersInsurance companies, claims departments
Common Search & Comparison IntentUnderstanding roles in claims processing and customer serviceAssessing damage, settling claims, fieldwork

Allstate Claims Resolution Specialists primarily handle customer inquiries and process claims in an office setting, focusing on customer service. In contrast, Allstate Claims Adjusters often conduct field inspections and assess damages directly at accident sites. Both roles require similar credentials but differ in work environment and responsibilities.

More about Allstate Claims Resolution Specialist jobs

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Cities with the most Allstate Claims Resolution Specialist job openings:

What states have the most Allstate Claims Resolution Specialist jobs?

States with the most job openings for Allstate Claims Resolution Specialist jobs include:

What job categories do people searching Allstate Claims Resolution Specialist jobs look for?

The top searched job categories for Allstate Claims Resolution Specialist jobs are:

Allstate Claims Resolution Specialist jobs near you
Infographic showing various Allstate Claims Resolution Specialist job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 85% Full Time, 12% Part Time, and 2% Contract. Highlights an 79% Physical, 2% Hybrid, and 19% Remote job distribution, with an average salary of $48,885 per year, or $23.5 per hour.

Claims Resolution Specialist

Integrated Pain Management Medical Group, Inc.

Walnut Creek, CA • On-site

$28 - $35/hr

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 26 days ago

Job description

The Claims Resolution Specialist is responsible for the day-to-day investigation and resolution of claim rejections, denials, edits, and reimbursement issues across a multi-site, multi-specialty healthcare organization specializing in pain management, physical medicine, and functional rehabilitation services.

Working closely with the Pre-Billing, Accounts Receivable (A/R), Denials Management, Coding, and Revenue Integrity teams, this position performs detailed claim reviews, researches payer requirements, corrects claim errors, and facilitates timely claim resubmission and payment. The Claims Resolution Specialist serves as a key resource in resolving billing issues and ensuring claims are processed accurately and efficiently.


*This is a remote role. We are only hiring in the following states: AZ, CA, NM, NV, OR, TX and WA.


What you will do:

Claims Resolution & Follow-Up

  • Investigate and resolve claim rejections, denials, and payer edits identified before or after claim submission.
  • Review claim history, payer correspondence, medical records, authorizations, and supporting documentation to determine the cause of claim issues.
  • Correct billing, coding, demographic, authorization, and insurance-related claim errors as appropriate.
  • Process claim corrections, adjustments, resubmissions, and reconsideration requests in accordance with payer guidelines.
  • Perform payer research and communicate directly with insurance carriers to resolve claim processing issues.
  • Monitor assigned work queues and ensure timely resolution of outstanding claims.
  • Escalate complex reimbursement, coding, or compliance issues to senior team members.

Denial Management Support

  • Partner with A/R and Denials Management teams to resolve denied and underpaid claims.
  • Assist in preparing appeal documentation and supporting materials for denied claims.
  • Identify recurring denial patterns and communicate findings to the Senior Claims Resolution Coordinator.
  • Maintain accurate documentation of denial resolution activities and payer communications.
  • Support efforts to reduce preventable denials and improve reimbursement outcomes.

Pre-Billing & Revenue Cycle Collaboration

  • Work closely with the pre-billing team to identify and correct claim issues prior to submission.
  • Review claims for completeness and compliance with payer billing requirements.
  • Verify insurance information, authorizations, referrals, diagnosis coding, procedure coding, and modifier usage.
  • Collaborate with coding and clinical teams to obtain information needed for claim resolution.
  • Assist with reducing claim holds and billing delays.

Audit & Compliance Support

  • Participate in routine claim quality reviews and internal audit activities.
  • Ensure claim corrections comply with payer regulations, organizational policies, and billing guidelines.
  • Support Revenue Integrity initiatives through accurate claim review and documentation.
  • Maintain knowledge of Medicare, Medicaid, Workers' Compensation, and Commercial payer requirements.
  • Adhere to HIPAA, CMS, and organizational compliance standards.

Documentation & Reporting

  • Maintain detailed documentation of claim investigations, resolutions, payer communications, and follow-up activities.
  • Track assigned workloads and resolution outcomes.
  • Assist with compiling information for denial trend reporting and operational reviews.
  • Provide feedback regarding workflow issues contributing to claim errors or payment delays.
  • Assumes other responsibilities as appropriate to the position and organizational needs



Qualifications:

  • High School Diploma or equivalent required.
  • Associate degree in Healthcare Administration, Medical Billing and Coding, or related field preferred.
  • Minimum 2-4 years of experience in medical billing, claims resolution, denial management, accounts receivable, or healthcare revenue cycle operations.
  • Working knowledge of Medicare, Medicaid, Workers' Compensation, and Commercial insurance billing requirements.
  • Knowledge of CPT, ICD-10-CM, HCPCS, modifiers, and medical terminology.
  • Experience researching and resolving denied or rejected claims.
  • Strong analytical and critical thinking skills.
  • Ability to manage multiple priorities and meet productivity expectations.


Compensation Range: 

$28.00 to $35.00 Hourly

All compensation ranges are posted based on internal equity, job requirements, experience, and geographical locations.


Why You'll Love Working Here:

  • Amazing work/life balance
  • Generous Medical, Dental, Vision, and Prescription benefits (PPO & HMO)
  • 401(K) Plan with Employer Matching
  • License & Tuition Reimbursements
  • Paid Time Off
  • Holiday Pay & Floating Holiday
  • Employee Perks and Discount Programs
  • Supportive environment to help you grow and succeed

Boomerang Healthcare (BHC) is a multidisciplinary and comprehensive team of experienced, committed healthcare providers that treat pain. Our team of doctors approaches each patient with one goal in mind: to help patients return to normal daily activities. We work with our patients to identify the cause of their pain and create a personalized treatment plan, recognizing that no two patients are alike, and neither is their pain. Our providers create a comprehensive care plan, then monitor, manage and coordinate patient access to health services at BHC. 

Boomerang Healthcare strives to be a diverse workforce that reflects, at all job levels, the patients we serve. We are an equal opportunity employer. Boomerang Healthcare is committed to compliance with the American Disabilities Act. If you require reasonable accommodation during the application process or have a question regarding an essential job function, please contact us.



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