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Case Resolution Specialist Jobs (NOW HIRING)

HMSA

Case Resolution Specialist II

Honolulu, HI · Hybrid

Identifies when changes to policies and procedures are needed based on case resolutions, statutory ... Assists with the implementation of resulting decisions for change/resolution. * Assists supervisor ...

HMSA

Case Resolution Specialist I

Honolulu, HI · Hybrid

Identifies when changes to policies and procedures are needed based on case resolutions, statutory ... Assists with the implementation of resulting decisions for change/resolution. * Assists supervisor ...

ZIM

Resolution Specialist

Virginia Beach, VA · On-site

The primary purpose of the Resolution Specialist is to manage and resolve customer disputes ... Facilitating communication with customers as it relates to their case. * Completion of Workflow for ...

ZIM

Resolution Specialist

Virginia Beach, VA · On-site +1

The primary purpose of the Resolution Specialist is to manage and resolve customer disputes ... Facilitating communication with customers as it relates to their case. * Completion of Workflow for ...

Archer Systems

Lien Resolution Specialist

Austin, TX · On-site

The Case Analyst ensures all cases are progressing towards completion and all duties ARCHER is ... Austin, TX (ON SITE) JOB RESPONSIBILITIES • Identify data required for lien resolution and ...

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Case Resolution Specialist information

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How much do case resolution specialist jobs pay per hour?

As of Jun 9, 2026, the average hourly pay for case resolution specialist in the United States is $20.76, according to ZipRecruiter salary data. Most workers in this role earn between $16.83 and $23.32 per hour, depending on experience, location, and employer.

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

AspectCase Resolution SpecialistClaims Adjuster
Required CredentialsHigh school diploma or equivalent; certifications varyHigh school diploma; licensing or certification often required
Work EnvironmentCustomer service centers, insurance companiesInsurance companies, field work, offices
Employer & Industry UsageInsurance, healthcare, legal sectorsInsurance industry primarily
Common Search & Comparison IntentUnderstanding job roles, responsibilities, and qualificationsComparing claims processing and settlement roles

The main difference is that a Case Resolution Specialist focuses on resolving customer cases, often involving communication and problem-solving, while a Claims Adjuster primarily evaluates insurance claims, investigates damages, and determines payouts. Both roles require strong communication skills and knowledge of insurance processes, but their daily tasks and focus areas differ.

What is a Case Resolution Specialist?

A Case Resolution Specialist is a professional responsible for managing and resolving customer or client cases, complaints, or disputes within an organization. They investigate issues, communicate with relevant parties, and work to find timely and satisfactory solutions. Case Resolution Specialists often document case details, follow company policies, and may suggest process improvements to prevent future issues. Their goal is to ensure customer satisfaction while maintaining compliance with regulations and company standards.

How does a Case Resolution Specialist typically collaborate with other departments to resolve client issues?

As a Case Resolution Specialist, you will often work closely with teams such as customer service, technical support, legal, and operations to gather information and coordinate solutions for complex client cases. Effective communication and a collaborative approach are essential, as you may need to facilitate meetings, share case updates, and ensure all stakeholders are aligned on resolution steps. This cross-functional teamwork not only speeds up case resolution but also helps in identifying process improvements for future cases.

What are the key skills and qualifications needed to thrive as a Case Resolution Specialist, and why are they important?

To thrive as a Case Resolution Specialist, you need strong problem-solving abilities, attention to detail, and a background in dispute resolution or customer service, often supported by a relevant degree or equivalent experience. Familiarity with CRM systems, case management software, and documentation tools is typically required. Excellent communication, patience, and negotiation skills help build rapport and facilitate effective conflict resolution. These competencies are crucial for efficiently resolving cases, maintaining customer satisfaction, and upholding organizational standards.
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Case Resolution Specialist jobs near you
Infographic showing various Case Resolution Specialist job openings in the United States as of May 2026, with employment types broken down into 2% As Needed, 76% Full Time, 18% Part Time, 1% Temporary, and 3% Contract. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution, with an average salary of $43,188 per year, or $20.8 per hour.
Case Resolution Specialist I

Case Resolution Specialist I

Hawaii Medical Service Association

Honolulu, HI • On-site

Full-time

Posted 11 days ago

Job description

  1. Conducts critical analysis of highly complex and sensitive member and provider appeals, inquiries and grievances and applies internal policies and procedures, contractual provisions, and regulatory requirements.
    • Secures information from internal and external resources to resolve issues.
    • Assists Supervisor and Coordinator in working as a liaison with providers, members and internal decision makers in representing HMSA objectives, goals, and expectations for meeting contractual, regulatory, and accreditation requirements.
    • Negotiates/resolves sensitive issues with internal and external parties.
    • Takes all facts and research from internal and external resources and presents a full explanation of the member's or provider's position and concerns to management and decision makers.
    • Triages cases to resolve them upon initial inquiry to best service the member as well as minimize the number of cases escalated to senior management and executives.
  2. At the direction and supervision of management, participates on cross departmental committees and other internal meetings to identify, clarify, research, and resolve inquiries and issues.
    • Identifies when changes to policies and procedures are needed based on case resolutions, statutory or regulatory changes, or accreditation requirements.
    • Proposes changes to management based on identification and analysis.
    • Analyzes and identifies issues that may require multiple department efforts to resolve.
    • Presents recommendations to internal committees, subgroups and executive management for decision making purposes as it relates to cases after discussion and approval from Supervisor and Coordinator.
    • Assists with the implementation of resulting decisions for change/resolution.
    • Assists supervisor/manager in responding to internal investigations, reviews, and audits; regulatory inquiries; and accreditation related audits.
    • Assist internal customers with complex member/physician inquiries with guidance and direction from management.
  3. Identifies member problems, member education needs, or trends and report these to manager, as well as recommend resolution. Takes a proactive role in reviewing, digesting and communicating any new regulation, standard, business change, etc. affecting the member advocacy and/or appeals process. At direction of management, assists in the coordination of changes among departments.
  4. Performs quality assurance of case documents and assists Supervisor and Manager with various corporate activities.
  5. Performs all other miscellaneous responsibilities and duties as assigned or directed.

#LI-Hybrid
  1. Bachelor's degree and one year of related work experience; or equivalent combination of education and related work experience.
  2. Effective verbal and written communication skills
  3. Problem identification and resolution skills
  4. Basic knowledge of Microsoft Office applications. Including but not limited to Word, Excel, Outlook, and Power Point.

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