Medical Claims Resolution Specialist
About The Position
Metro Vein Centers is a rapidly growing healthcare practice specializing in state-of-the-art vein treatments. Our board-certified physicians and expert staff are on a mission to improve people’s quality of life by relieving the painful, yet highly treatable symptoms of vein disease—such as varicose veins and heavy, aching legs. With over 60 clinics across 7 states, and still growing, we’re building the future of vein care—delivering compassionate, results-driven care in a modern, patient-first environment. We proudly maintain a Net Promoter Score (NPS) of 93, the highest patient satisfaction in the industry. We’re seeking a detail-oriented, results-driven Claims Resolution Specialist to support our billing and revenue cycle operations. In this role, you’ll manage assigned claims, follow up on denials, ensure accurate and timely payment, and support the financial health of our clinics through effective payer engagement. This is a hybrid position based in West Bloomfield, MI, with 2–3 days onsite per week depending on training, performance, and departmental needs.
Requirements
- 2+ years of experience in medical billing, claims resolution, or insurance follow-up
- 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
Benefits
- Medical, Dental, and Vision Insurance
- 401(k) with Company Match
- Paid Time Off (PTO) + Paid Company Holidays
- Company-Paid Life Insurance
- Short-Term Disability Insurance
- Employee Assistance Program (EAP)
- Career Growth & Development Opportunities
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
