Claims Resolution Specialist

Metro Vein Centers•West Bloomfield, MI

8h•Remote

About The Position

Metro Vein Centers is seeking a detail-oriented, results-driven Claims Resolution Specialist to support our billing and revenue cycle operations. In this role, you will manage assigned claims, follow up on denials, ensure accurate and timely payment, and support the financial health of our clinics through effective payer engagement.

Requirements

4+ years of experience in medical billing, claims resolution, or insurance follow-up
1+ years experience working remotely
Solid understanding of insurance guidelines, claim cycles, and payer behavior
Proficiency with CPT, ICD-10, and medical billing workflows
Comfortable using payer portals, EMR systems, and Excel/Google Sheets
Organized, self-motivated, and accountable with strong time management skills
Clear written and verbal communication when working with both payers and internal teams
High school diploma or equivalent required

Nice To Haves

Familiarity with Centricity EMR
Previous experience in surgical or specialty practice billing
Knowledge of revenue cycle metrics and KPIs

Responsibilities

Investigate and resolve claim denials and underpayments from insurance providers
Research payer-specific policies and submit accurate, timely appeals
Follow up on unpaid or delayed claims using payer portals and internal billing systems
Monitor aging reports and prioritize claims follow-up based on timely filing and payer deadlines
Perform insurance re-verification as needed and reprocess claims to appropriate payers
Accurately post payments and adjustments, including co-payments, deductibles, and coinsurance
Support billing operations, including charge entry, rejection resolution, and documentation reviews
Collaborate with internal teams to escalate payer issues and reduce future denials
Maintain meticulous records of follow-ups, appeal status, and payment resolutions in the EMR