Claims & Benefits Resolution Specialist

Job Description

Job Title : Claims & Benefits Resolution Specialist

Pay Rate : $25.00-$26.00

Start Date : 12-22-2025

Location : West Valley City, UT 84120

(Training Onsite; Remote After Training with 1 Required Onsite Day / Month)

Department : Revenue Cycle Management – Central Business Office

Assignment Length : 3 Months (Potential Extension)

Top Things Needed :

• Minimum 2–3 years of experience in healthcare revenue cycle, claims processing, eligibility / benefits, or authorizations.
• Strong understanding of payer rules, reimbursement methodologies, and claims adjudication.
• Familiarity with Epic, payer portals, and other claims / RCM systems.
• High accuracy in auditing and error resolution work.
• Experience resolving complex claim issues across multiple systems.
• Ability to work independently, troubleshoot problems, and drive claims to completion
• Strong communication skills for interacting with payers, internal teams, and leadership.
• Comfortable with onsite onboarding and required monthly onsite days.
• Experience working in a Central Business Office or Shared Services model.
• Prior experience supporting Utah-based payer populations or multi-state payer networks.

JOB DESCRIPTION :

Our client is seeking a Claims & Benefits Resolution Specialist for a contract opportunity. This role performs comprehensive audits and resolution activities across the claims lifecycle, ensuring accurate billing, timely reimbursement, and compliance with payer requirements. The specialist will handle complex claim discrepancies, conduct follow-up with payers, and coordinate with clinical and non-clinical teams to finalize claim determinations. The ideal candidate has strong revenue cycle experience, particularly in claims, eligibility, benefits, and authorizations, and can quickly identify root-cause errors in a high-volume environment.

This is an operational “fix-it” position — the manager needs someone who doesn’t just process claims but can find what’s broken and correct it without hand-holding.

Key Responsibilities :

Required Skills & Experience :