Claims Research & Resolution Representative

This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Claims Research & Resolution Representative based in the United States.

This remote role is an opportunity to combine customer service, claims research, and problem-solving within a large healthcare environment.
You will investigate claims and claims-related financial issues while supporting members, providers, insurance partners, and other stakeholders.
The position involves handling inbound inquiries, conducting follow-up, researching information across multiple systems, and resolving moderately complex issues.
You will use your judgment to interpret policies, prioritize competing tasks, and determine appropriate resolutions with limited supervision.
The role offers structured training, cross-functional learning, and opportunities to strengthen your healthcare claims and customer service expertise.
Success requires strong organization, technical confidence, confidentiality, and the ability to communicate clearly in a remote call-center setting.
You will play an important role in helping customers and providers navigate claims questions and reach timely, accurate resolutions.