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Insurance Resolution Specialist Jobs (NOW HIRING)

GPRS

Account Resolution Specialist

Toledo, OH · On-site

$14.25 - $19.75/hr

The Account Resolution Specialist is responsible for collecting payment on every open invoice that ... We offer full medical, dental, and vision insurance with day-one coverage, 401k with company ...

ECMC Group

Account Resolution Specialist

Minneapolis, MN · On-site

$20 - $23/hr

Job Summary Under direct supervision, the Account Resolution Specialist provides default resolution ... Medical, dental, and vision insurance plan options, with a generous employer subsidy. Company paid ...

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 ... Our dynamic team has the responsibility of resolving outstanding insurance claims so that our ...

Upgrade

Dispute Resolution Specialist

Atlanta, GA · Hybrid

The Dispute Resolution Specialist is responsible for the customer dispute process involving ... vision insurance * Flexible PTO * Competitive 401(k) and RRSP program * Opportunities for ...

LHH US

Claims Resolution Specialist

Cincinnati, OH

$19 - $23/hr

Claims Resolution Specialist Cincinnati, Ohio Contract-to-hire Pay: $19 to $23 LHH Recruitment ... insurance carriers, patients, and internal stakeholders. Responsibilities: • Manage workflow ...

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All JobsInsurance Resolution Specialist Jobs

Insurance Resolution Specialist information

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$13

$28

$55

How much do insurance resolution specialist jobs pay per hour?

As of Jul 13, 2026, the average hourly pay for insurance resolution specialist in the United States is $28.72, according to ZipRecruiter salary data. Most workers in this role earn between $18.99 and $36.06 per hour, depending on experience, location, and employer.

How to be a resolution specialist?

To become an Insurance Resolution Specialist, you typically need a high school diploma or equivalent, with some roles preferring a bachelor's degree in fields like business or insurance. Relevant skills include strong communication, problem-solving, and knowledge of insurance policies and claims processes. Certification programs such as the Certified Insurance Counselor (CIC) can enhance your qualifications, and experience in customer service or claims adjustment is often beneficial.

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

To thrive as an Insurance Resolution Specialist, you need strong analytical skills, attention to detail, and a solid understanding of insurance policies and claim procedures, often supported by experience in healthcare billing or insurance. Familiarity with claims management software, electronic health record (EHR) systems, and knowledge of medical coding (such as ICD-10 and CPT) are typically required. Excellent communication, problem-solving abilities, and persistence help professionals navigate disputes and collaborate with insurance companies and healthcare providers. These skills are crucial for efficiently resolving claim issues, minimizing denials, and ensuring timely reimbursement for services rendered.

How much do insurance specialists make in the US?

Insurance Resolution Specialists typically earn between $40,000 and $65,000 annually, depending on experience, location, and employer. They often require strong communication skills and knowledge of insurance policies to effectively resolve claims and disputes.

What are some common challenges faced by Insurance Resolution Specialists, and how are they typically addressed?

Insurance Resolution Specialists often encounter challenges such as navigating complex policy details, managing high volumes of claim disputes, and communicating with multiple stakeholders including clients, insurance carriers, and healthcare providers. These challenges are typically addressed by developing strong analytical and problem-solving skills, maintaining meticulous documentation, and fostering effective communication. Many teams also use specialized case management software and regular training sessions to stay updated on industry regulations and best practices, which supports efficient resolution of claims and enhances job performance.

Do I need a degree to be a claims specialist?

Insurance resolution specialists typically do not require a college degree, but employers often prefer candidates with a high school diploma or equivalent. Relevant skills include knowledge of insurance policies, strong communication, and attention to detail; certifications like the Certified Claims Professional (CCP) can enhance job prospects.

What does an Insurance Resolution Specialist do?

An Insurance Resolution Specialist is responsible for handling and resolving issues related to insurance claims. They investigate discrepancies, communicate with insurance companies, and ensure claims are processed accurately and in a timely manner. Their role involves reviewing claim denials, appealing decisions, and working closely with patients, healthcare providers, and insurers to resolve billing or payment issues. Ultimately, they help ensure that claims are paid correctly and that any problems are addressed efficiently.

What position in insurance pays the most?

In insurance, executive roles such as Chief Underwriting Officer, Chief Risk Officer, or Chief Claims Officer typically have the highest salaries. These positions require extensive experience, leadership skills, and often advanced certifications, and they oversee large teams and strategic decision-making within insurance companies.

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

AspectInsurance Resolution SpecialistClaims Adjuster
Required CredentialsHigh school diploma or equivalent; certifications like CPCU or ARM beneficialHigh school diploma or equivalent; licensing may be required depending on state
Work EnvironmentOffice settings, customer service interactions, claims processingField work and office settings, investigating claims
Employer & Industry UsageInsurance companies, third-party administratorsInsurance companies, independent adjusting firms
Common Search & ComparisonInsurance Resolution Specialist vs Claims Adjuster

The main difference is that Insurance Resolution Specialists focus on resolving customer issues and managing claims through communication and documentation, often working in customer service roles. Claims Adjusters investigate and evaluate claims, sometimes in the field, to determine coverage and settlement. Both roles require knowledge of insurance policies, but their daily tasks and work environments differ slightly.

More about Insurance Resolution Specialist jobs
What job categories do people searching Insurance Resolution Specialist jobs look for? The top searched job categories for Insurance Resolution Specialist jobs are:
Insurance Resolution Specialist jobs near you
Infographic showing various Insurance Resolution Specialist job openings in the United States as of July 2026, with employment types broken down into 1% As Needed, 72% Full Time, 22% Part Time, and 5% Contract. Highlights an 91% Physical, 1% Hybrid, and 8% Remote job distribution, with an average salary of $59,736 per year, or $28.7 per hour.
Resolution Specialist

Resolution Specialist

The Gray Insurance Company

Metairie, LA

Full-time

Medical, Retirement, PTO

Re-posted 7 days ago

Job description

What you’d be doing:

  • Investigate Commercial Auto and General Liability claims
  • Verify policy coverage
  • Communicate clearly and promptly with insureds, claimants, and plaintiff attorneys
  • Assess exposure and set reserves within your authority level
  • Develop strategies and action plans to resolve claims efficiently
  • Utilize experts to assess liability and damages
  • Manage defense counsel on pre-suit and litigated matters
  • Participate in mediations
  • Maintain thorough documentation, diary notes, and status updates
  • Conduct onsite visits, attend meetings, and participate in claim file reviews
  • Engage in team initiatives and process improvement
  • Identify and report suspected fraud
  • Identify subrogation opportunities
  • Ensure compliance with Medicare Section 111 and other regulations
  • Stay updated with industry developments and maintain CE credits
  • Work pro-actively with a sense of urgency
  • Mentor team members and support the Team Lead/Manager as needed

We’re looking for someone who has:

  • A valid adjuster license in applicable jurisdictions
  • At least 3 years of experience handling liability claims
  • Excellent written and verbal communication skills
  • Strong proficiency with Microsoft Office and claims management software
  • Ability to manage a caseload independently and meet deadlines
  • Professional demeanor, keen attention to detail, and a team-oriented approach

Preferred candidates may have:

  • Bachelor’s degree
  • Experience supervising or mentoring peers
  • A background working on litigated claims
  • Experience participating in mediations and working directly with defense counsel
  • Industry designations (AIC, CPCU)

 

About The Gray Insurance Company:

Named among the Top Workplaces by the Times-Picayune for six years in a row, The Gray Insurance Company’s mission is to provide innovative risk management solutions and positively impact the people we serve. We strive to be the leader in our market by changing how people think about insurance. We offer exceptional products and services and provide value through a workforce inspired to serve each other, our customers and our communities. Our core values are proud professionalism, responsive service, proactive improvement, integrity and, above all, family.

TGIC offers a comprehensive benefits package including robust health coverage, wellness coaching, 10 paid holidays, generous vacation time plus additional days of paid time off, paid volunteer time off, a 401k plan, profit sharing and more.

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