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Live In Claims Resolution Specialist Jobs (NOW HIRING)

Select Medical

Claims Resolution Specialist

Camp Hill, PA · On-site

$18.50/hr

OverviewClaims Resolution Specialist (in-office - on-site role) Starting at $18.50/hr but flexible ... If so, our Claims Resolution Specialist position may be a phenomenal career for you within Select ...

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 ...

TEKsystems

Claims Resolution Specialist

Pompano Beach, FL · On-site

$21.68 - $24.40/hr

... claims, and/or missing data - Record invoices for all procedures and associated billing codes ... As an industry leader in Full-Stack Technology Services, Talent Services, and real-world ...

Encova Insurance

Injury Resolution Specialist

Concord, NC · Remote

$69K - $110K/yr

Encova Insurance has an immediate opening for an Injury Resolution Specialist. This role will be ... Maintain competency in the use of multiple claims systems and manage efficient and effective ...

VieMed

Claims Resolution Specialist

Lafayette, LA · On-site

Claims generation * Establishes and maintains effective communication and good working ... Experience: * 3-5 Years in DME or medical billing experience preferred. * Minimum of 1 year of ...

VieMed

Claims Resolution Specialist

Lafayette, LA · On-site

$14 - $18.50/hr

Claims generation * Establishes and maintains effective communication and good working ... Experience: * 3-5 Years in DME or medical billing experience preferred. * Minimum of 1 year of ...

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Live In Claims Resolution Specialist information

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How much do live in claims resolution specialist jobs pay per hour?

As of Sep 1, 2026, the average hourly pay for live in 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 is the difference between Live In Claims Resolution Specialist vs Claims Adjuster?

AspectLive In Claims Resolution SpecialistClaims Adjuster
CredentialsRelevant insurance certifications, claims trainingInsurance licenses, certifications often required
Work EnvironmentOn-site, often in client homes or officesOffice-based or remote, fieldwork possible
Employer & IndustryInsurance companies, third-party administratorsInsurance carriers, independent agencies
Search & Comparison IntentSimilar roles handling claims, resolution processClaims processing, settlement, and adjustment

Both roles involve handling insurance claims, but Live In Claims Resolution Specialists typically work directly with clients on-site to resolve claims, while Claims Adjusters often work in offices or remotely to evaluate and settle claims. The roles share similar certifications and industry usage, but differ mainly in work environment and daily responsibilities.

What is a live in claims resolution specialist?

A live-in claims resolution specialist is a professional who works on-site to review, investigate, and resolve insurance claims promptly. They often handle complex cases, communicate directly with claimants, and may use specialized software to assess coverage and settlement options, typically working full-time in an office or client environment.

What cities are hiring for Live In Claims Resolution Specialist jobs?

Cities with the most Live In Claims Resolution Specialist job openings:

What are the most commonly searched types of Claims Resolution Specialist jobs?

The most popular types of Claims Resolution Specialist jobs are:

What states have the most Live In Claims Resolution Specialist jobs?

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

Live In Claims Resolution Specialist jobs near you

Claims Resolution Specialist

Integrated Pain Management Medical Group, Inc.

Walnut Creek, CA • On-site

$28 - $35/hr

Full-time

Re-posted 11 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.