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Case Resolution Specialist Jobs (NOW HIRING)

Ntta

$18.50/hr

The Customer Resolution Specialist provides a single point of contact resolution approach to ... with case resolution, emails and calls. * Participate in team meetings to stay updated on NTTA ...

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 ...

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How much do case resolution specialist jobs pay per hour?

As of Jul 20, 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
Grievance Resolution Specialist (Provider Resolution)

Grievance Resolution Specialist (Provider Resolution)

Aroha Technologies

Orange, CA • On-site

$24 - $32/wk

Contractor

Posted 13 days ago

Job description

Grievance Resolution Specialist (Provider Resolution)

Job Title: Grievance Resolution Specialist (Provider Resolution)

Location: Orange County, CA (500 City Parkway West)

Work Schedule: Monday – Friday | 8:00 AM – 5:00 PM

Work Setting: 100% Onsite

Job Overview

We are seeking a detail-oriented Grievance Resolution Specialist (Provider Resolution) to support the Grievance & Appeals department. In this role, you will investigate provider grievances and appeals, coordinate with internal teams, communicate with providers, and ensure timely, accurate case resolution while maintaining compliance with healthcare regulations.

Key Responsibilities
  • Review and process provider grievances and appeals.
  • Gather, analyze, and document case information.
  • Create and maintain accurate case records and reports.
  • Communicate with providers and internal departments regarding case status.
  • Research provider contracts, policies, and regulatory requirements.
  • Draft professional resolution letters and correspondence.
  • Respond to provider inquiries by phone and email.
  • Coordinate with operational teams to resolve complex issues.
  • Identify trends and recommend process improvements.
  • Maintain confidentiality and comply with healthcare regulations.
  • Perform additional administrative duties as assigned.
Minimum Qualifications
  • High School Diploma or GED.
  • At least 1 year of experience in one or more of the following:
    • Provider Dispute Resolution
    • Medicare or Medi-Cal Appeals
    • Grievance & Appeals
    • Claims Administration
    • Regulatory Compliance
    • Healthcare Customer Service
  • Strong written and verbal communication skills.
  • Ability to work independently and manage multiple priorities.
  • Proficiency in Microsoft Office (Word, Excel, Outlook, PowerPoint).
Preferred Qualifications
  • Associate degree in Business, Healthcare Administration, or a related field.
  • Experience with healthcare practice standards for government and commercial health plans.
  • Bilingual candidates (Spanish, Vietnamese, Chinese, Korean, Arabic, Farsi, or Russian) are encouraged to apply.
Skills
  • Strong analytical and problem-solving abilities
  • Excellent organizational skills
  • Attention to detail
  • Ability to manage multiple cases simultaneously
  • Professional customer service skills
  • Team-oriented with the ability to build positive working relationships
     
Thanks, and regards, 
Nick Glenn 
Healthcare Recruiter 
Direct: 510-455-4449
Aroha Technologies Inc.
www.arohatechnologies.com