ZipRecruiter

Log In

1

Resolution Processing Jobs in California (NOW HIRING)

Gallagher

Senior Resolution Manager

Sacramento, CA · Remote

Whether you're managing claims, supporting clients, or improving processes, you'll play a vital ... resolution. * Provide exceptional customer service to our claimants on behalf of our clients ...

Provest LLC

Process Specialist

San Diego, CA · On-site

Expedite resolution of errors made by Process Servers on submitted affidavits. * Create and maintain logs for tracking purposes. * Punctual and regular attendance. * Perform other duties as assigned.

Raymond Corporation

Processor

Cypress, CA

$19 - $21/hr

Prioritize incomplete and aging work orders through to resolution. * Processor will work with accounting department on credits and invoice disputes to resolution. Required Skills/Abilities:

The Raymond Corporation

Processor

Cypress, CA · On-site

$19 - $21/hr

Prioritize incomplete and aging work orders through to resolution. * Processor will work with accounting department on credits and invoice disputes to resolution. Required Skills/Abilities:

The Raymond Corporation

Processor

Cypress, CA · On-site

$19 - $21/hr

Prioritize incomplete and aging work orders through to resolution. * Processor will work with accounting department on credits and invoice disputes to resolution. Required Skills/Abilities:

Raymond West

Processor

Cypress, CA · On-site

$19 - $21/hr

Prioritize incomplete and aging work orders through to resolution. * Processor will work with accounting department on credits and invoice disputes to resolution. Required Skills/Abilities:

previous page

Showing results 41-60

All JobsResolution Processing JobsResolution Processing Jobs in California

Resolution Processing information

What is the difference between Resolution Processing vs Claims Processor?

AspectResolution ProcessingClaims Processor
Required CredentialsHigh school diploma or equivalent; some roles may require insurance or claims processing certificationsHigh school diploma or equivalent; often requires insurance or claims processing certifications
Work EnvironmentOffice settings, call centers, or remote work; primarily administrative and customer serviceOffice or remote; handling insurance claims, data entry, and customer communication
Industry UsageInsurance, healthcare, financeInsurance, healthcare, government agencies
Common Search/ComparisonResolution Processing vs Claims Processor

Resolution Processing and Claims Processors both handle insurance-related tasks, often in similar environments. Resolution Processing typically focuses on resolving claims issues, discrepancies, or appeals, while Claims Processors primarily review and process insurance claims from submission to payout. Both roles require similar credentials and are used across insurance and healthcare industries. Understanding their differences helps job seekers identify the right career path within the claims and resolution field.

What are popular job titles related to Resolution Processing jobs in California?

For Resolution Processing jobs in California, the most frequently searched job titles are:

What job categories do people searching Resolution Processing jobs in California look for?

The top searched job categories for Resolution Processing jobs in California are:

What cities in California are hiring for Resolution Processing jobs?

Cities in California with the most Resolution Processing job openings:

Resolution Processing jobs near you

Claims Resolution Specialist

Integrated Pain Management Medical Group, Inc.

Walnut Creek, CA • On-site

$28 - $35/hr

Full-time

Re-posted 14 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.