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Provider Claim Resolution Specialist Jobs (NOW HIRING)

Encova Insurance

Injury Resolution Specialist

Columbus, OH · On-site

$69K - $110K/yr

Proactively manage and continuously evaluate the claim with specific emphasis on the nature and ... It provides an accurate overview of the work and skills needed to perform this position. Because ...

Encova Insurance

Injury Resolution Specialist

$69K - $110K/yr

Proactively manage and continuously evaluate the claim with specific emphasis on the nature and ... It provides an accurate overview of the work and skills needed to perform this position. Because ...

Encova Mutual Insurance Group.

$80 - $100/hr

Proactively manage and continuously evaluate the claim with specific emphasis on the nature and ... It provides an accurate overview of the work and skills needed to perform this position. Because ...

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Encova Insurance

Injury Resolution Specialist

Concord, NC · Remote

$69K - $110K/yr

Proactively manage and continuously evaluate the claim with specific emphasis on the nature and ... It provides an accurate overview of the work and skills needed to perform this position. Because ...

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How much do provider claim resolution specialist jobs pay per hour?

As of Sep 9, 2026, the average hourly pay for provider claim 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.

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Infographic showing various Provider Claim Resolution Specialist job openings in the United States as of August 2026, with employment types broken down into 3% As Needed, 76% Full Time, 15% Part Time, and 6% Contract. Highlights an 93% Physical, 1% Hybrid, and 6% Remote job distribution, with an average salary of $59,736 per year, or $28.7 per hour.

Claims Resolution Specialist 1 - USFTGP UMSA RCO Back End

Tampa, FL • On-site

Tampa General Hospital
Hospitals • 5 - 10K employees
Learn more about Tampa General Hospitalexternal

Full-time

Re-posted 20 days ago

Tampa General Hospital rating

7.4

Company rating: 7.4 out of 10

Based on 163 frontline employees who took The Breakroom Quiz

339th of 1,066 rated hospitals

Job description

The Claims Resolution Specialist I is responsible for the timely and accurate submission, followup, and resolution of thirdparty insurance claims to ensure correct reimbursement for services rendered. This position reviews assigned accounts, conducts status inquiries, processes appeals, and determines appropriate actions needed to resolve outstanding balances in accordance with departmental policies, payer guidelines, and regulatory requirements. The Specialist identifies trends impacting claims, assists with clean claim filing, and participates in special projects related to accounts receivable management. The role requires effective communication with payers, attention to detail, and adherence to State, Federal, and carrier regulations to support optimal financial performance for the organization. 

Required:

High School Diploma or GED

Work Experience and Additional Information 

2 years' experience in physician billing and collection experience  

CPT ICD10 experience 

Experience with EPIC software

Technical Knowledge, Skills, and Abilities

  • Understanding of thirdparty payer processes, claim workflows, denial reasons, and reimbursement methodologies. 
  • Knowledge of State and Federal regulations, payer policies, appeal requirements, and compliance standards related to insurance claims. 
  • Ability to analyze claim issues, identify trends, determine root causes, and recommend solutions that support clean claim submission and reduce denials. 
  • Strong written and verbal communication skills for contacting payers, preparing appeals, and documenting claim activity accurately and professionally. 
  • Skills to manage a highvolume workload, prioritize tasks, meet deadlines, and follow department protocols to ensure timely claim resolution. 
  • Ability to use billing systems, claim scrubbers, payer portals, and standard office software to review accounts, submit appeals, and track claim status. 

What Tampa General Hospital employees say

Pay

Benefits

Hours and flexibility

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About Tampa General Hospital

Sourced by ZipRecruiter

Tampa General Hospital was named the #1 hospital in Tampa Bay by U.S. News & World Report, 2020-2021, and recognized as one of America's Best Hospital's in five medical specialties: Cardiology & Heart Surgery, Diabetes & Endocrinology, Gastroenterology & GI Surgery, Nephrology, and Orthopedics. Tampa General Hospital has been designated a Magnet Hospital by the American Nurses Credentialing Center (ANCC), the highest recognition for nursing excellence, for the fourth consecutive time - an accomplishment that fewer than one percent of hospitals nationwide have earned. TGH is accredited by The Joint Commission and was awarded disease-specific certification in five medical specialties. TGH is also accredited by the Commission on Accreditation of Rehabilitation Facilities (CARF). *Air transport provided by Metro Aviation, Inc.

Industry

Hospitals

Company size

5,001 - 10,000 Employees

Headquarters location

Tampa, FL, US

Year founded

1927

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