Medical Claims Resolution Specialist
or drop it." It doesn't forbid a brief intro paragraph before headings. We can include a short paragraph about the company as context, but not as a heading. That's allowed. We need to output only HTML fragment, no /. Use
for section headings. Use - for any list of duties/requirements/benefits, and
for prose.
We must not include sections with filler like "commensurate with experience". Not present.
We need to decide sections:
- About the role: maybe a paragraph summarizing role purpose.
- Responsibilities: combine "What Your Day Looks Like" and "What You’ll Do". Could be a list.
- Requirements: Education & Experience (high school diploma, 2+ years experience, etc.) plus maybe "Prior experience with surgical, specialty practice..." etc.
- Qualifications: maybe same as Requirements? Could combine.
- Skills: "What You’ll Bring" list.
- Benefits: list.
- Schedule: schedule info.
We should avoid duplicate content. Let's extract details.
Company intro (first paragraph): "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 70 clinics across 9 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 can include that as a brief intro
before headings.
Now role description: "Metro Vein Centers is seeking a detail-oriented Medical Claims Resolution Specialist to support our billing and revenue cycle operations.This role is responsible for resolving denied, underpaid, and aging insurance claims while helping ensure accurate reimbursement and timely account resolution. You’ll work directly with insurance payers, payer portals, billing systems, and internal operational teams to investigate claim issues, submit appeals, and reduce revenue delays across our growing national clinic network.The ideal candidate has prior experience in medical billing, insurance follow-up, denial resolution, or accounts receivable within a healthcare environment. Success in this role requires strong problem-solving skills, attention to detail, urgency, and the ability to manage high claim volumes while navigating complex payer guidelines.This is a fully remote role supporting Metro Vein Centers’ growing national operations. The ideal candidate is highly organized, detail-oriented, and comfortable working independently in a fast-paced, high-volume claims environment."
We can put that as About the role (
About the role
...
).
Now responsibilities: combine "What Your Day Looks Like" bullet points and "What You’ll Do" bullet points.
List from "What Your Day Looks Like":
- Investigating denied or underpaid medical claims
- Following up with insurance payers through portals and phone communication
- Reviewing payer guidelines and submitting claim appeals
- Managing aging reports and prioritizing time-sensitive accounts
- Reprocessing claims and updating billing information within the EMR system
- Collaborating with billing, coding, and operational teams to resolve claim issues
- Managing multiple claims simultaneously while maintaining productivity and accuracy standards
List from "What You’ll Do":
- Investigate and resolve denied, unpaid, or underpaid insurance claims
- Submit timely and accurate appeals based on payer-specific guidelines and supporting documentation
- Follow up on aging claims through payer portals, phone calls, and billing systems
- Review claim edits, rejections, and payment discrepancies to determine resolution steps
- Perform insurance re-verification and reprocess claims as needed
- Post adjustments, payments, and account updates accurately within the EMR system
- Maintain detailed documentation regarding claim follow-up activity and payer communication
- Collaborate with internal billing, coding, and operational teams to reduce recurring denials and reimbursement delays
- Support departmental productivity, quality, and turnaround time expectations
We can merge, removing duplicates. Many overlap. We'll create a unified list, ensuring we keep all distinct items.
Let's enumerate distinct responsibilities:
1. Investigate denied or underpaid medical claims (investigate and resolve denied, unpaid, or underpaid insurance claims) – combine.
2. Follow up with insurance payers through portals and phone communication (follow up on aging claims through payer portals, phone calls, and billing systems) – similar.
3. Review payer guidelines and submit claim appeals (submit timely and accurate appeals based on payer-specific guidelines and supporting documentation).
4. Manage aging reports and prioritize time-sensitive accounts.
5. Reprocess claims and update billing information within the EMR system (reprocess claims as needed; post adjustments, payments, and account updates accurately within the EMR system).
6. Collaborate with billing, coding, and operational teams to resolve claim issues (collaborate with internal billing, coding, and operational teams to reduce recurring denials and reimbursement delays).
7. Manage multiple claims simultaneously while maintaining productivity and accuracy standards (support departmental productivity, quality, and turnaround time expectations).
8. Review claim edits, rejections, and payment discrepancies to determine resolution steps.
9. Perform insurance re-verification.
10. Maintain detailed documentation regarding claim follow-up activity and payer communication.
We'll keep all.
Now Requirements/Education & Experience:
- High school diploma or equivalent required.
- 2+ years of experience in medical billing, insurance follow-up, denial resolution, claims management, or healthcare revenue cycle operations required.
- Prior experience with surgical, specialty practice, outpatient, or procedural billing strongly preferred.
- Familiarity with Centricity / Athena EMR preferred.
- Experience reviewing appeals, denials, EOBs, and payer correspondence strongly preferred.
Also "This Role Is Great For Candidates With Experience In:" list: Medical Billing, Claims Resolution, Insurance Follow-Up, Denial Management, Accounts Receivable (AR), Revenue Cycle Management, Healthcare Billing, Payer Appeals, Medical Collections, Specialty Medical Billing, Surgical Billing, Healthcare Administration.
We could treat that as Skills or maybe as additional qualifications.
Now "What You’ll Bring" list:
- Ability to work independently and maintain productivity in a fully remote environment
- Strong understanding of medical billing, claims follow-up, denial management, and insurance workflows
- Knowledge of CPT, ICD-10, EOBs, payer guidelines, and medical billing terminology
- Comfortable navigating payer portals, EMR systems, and healthcare billing platforms
- Strong analytical and problem-solving skills with attention to detail
- Ability to manage multiple claims and deadlines within a fast-paced environment
- Clear written and verbal communication skills when working with payers and internal teams
- Organized, self-motivated, and accountable work style
Now 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
Now Schedule & Location:
- Fully remote position
- Standard business hours Monday–Friday
- Candidates must have reliable internet access and a distraction-free remote work environment
Now we need to output HTML with headings for sections that have content.
We need to decide which headings to use: About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Schedule. Possibly also "Preferred Qualifications" but not needed.
We must not include Pay section.
We need to avoid duplication: we have Requirements (education/experience) and Qualifications (maybe preferred experience) and Skills (What You’ll Bring). Could combine Requirements and Qualifications into one section? But instruction: Prefer a few substantive sections over many thin ones. So we could merge Education & Experience and Preferred Experience into a "Requirements" section, and Skills into a "Skills" section. Or we could have "Requirements" for mandatory, "Preferred Qualifications" for preferred, and "Skills" for abilities. That's three sections, still okay.
But we need to ensure we don't create thin sections with little content. Each will have decent list.
Let's plan:
About the role
... (company intro + role description)
Responsibilities
- ... list ...
Requirements
- ... mandatory: high school diploma, 2+ years experience ...
Preferred Qualifications
- ... prior experience with surgical/specialty practice..., familiarity with Centricity/Athena EMR, experience reviewing appeals, denials, EOBs, payer correspondence ...
Skills
- ... ability to work independently..., strong understanding..., knowledge..., comfortable navigating..., strong analytical..., ability to manage multiple claims..., clear communication..., organized self-motivated ...
Benefits
- ... benefits list ...
Schedule
- ... fully remote, standard business hours Monday–Friday, reliable internet, distraction-free environment ...
We need to ensure we don't repeat content. Let's craft each.
First, About the role paragraph: combine company intro and role description. Must not repeat job title. Provide concise but preserve all substantive info.
Company intro: "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 70 clinics across 9 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."
Role description: "Met
for prose. We must not include sections with filler like "commensurate with experience". Not present. We need to decide sections: - About the role: maybe a paragraph summarizing role purpose. - Responsibilities: combine "What Your Day Looks Like" and "What You’ll Do". Could be a list. - Requirements: Education & Experience (high school diploma, 2+ years experience, etc.) plus maybe "Prior experience with surgical, specialty practice..." etc. - Qualifications: maybe same as Requirements? Could combine. - Skills: "What You’ll Bring" list. - Benefits: list. - Schedule: schedule info. We should avoid duplicate content. Let's extract details. Company intro (first paragraph): "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 70 clinics across 9 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 can include that as a brief intro
before headings. Now role description: "Metro Vein Centers is seeking a detail-oriented Medical Claims Resolution Specialist to support our billing and revenue cycle operations.This role is responsible for resolving denied, underpaid, and aging insurance claims while helping ensure accurate reimbursement and timely account resolution. You’ll work directly with insurance payers, payer portals, billing systems, and internal operational teams to investigate claim issues, submit appeals, and reduce revenue delays across our growing national clinic network.The ideal candidate has prior experience in medical billing, insurance follow-up, denial resolution, or accounts receivable within a healthcare environment. Success in this role requires strong problem-solving skills, attention to detail, urgency, and the ability to manage high claim volumes while navigating complex payer guidelines.This is a fully remote role supporting Metro Vein Centers’ growing national operations. The ideal candidate is highly organized, detail-oriented, and comfortable working independently in a fast-paced, high-volume claims environment." We can put that as About the role (
About the role
...
). Now responsibilities: combine "What Your Day Looks Like" bullet points and "What You’ll Do" bullet points. List from "What Your Day Looks Like": - Investigating denied or underpaid medical claims - Following up with insurance payers through portals and phone communication - Reviewing payer guidelines and submitting claim appeals - Managing aging reports and prioritizing time-sensitive accounts - Reprocessing claims and updating billing information within the EMR system - Collaborating with billing, coding, and operational teams to resolve claim issues - Managing multiple claims simultaneously while maintaining productivity and accuracy standards List from "What You’ll Do": - Investigate and resolve denied, unpaid, or underpaid insurance claims - Submit timely and accurate appeals based on payer-specific guidelines and supporting documentation - Follow up on aging claims through payer portals, phone calls, and billing systems - Review claim edits, rejections, and payment discrepancies to determine resolution steps - Perform insurance re-verification and reprocess claims as needed - Post adjustments, payments, and account updates accurately within the EMR system - Maintain detailed documentation regarding claim follow-up activity and payer communication - Collaborate with internal billing, coding, and operational teams to reduce recurring denials and reimbursement delays - Support departmental productivity, quality, and turnaround time expectations We can merge, removing duplicates. Many overlap. We'll create a unified list, ensuring we keep all distinct items. Let's enumerate distinct responsibilities: 1. Investigate denied or underpaid medical claims (investigate and resolve denied, unpaid, or underpaid insurance claims) – combine. 2. Follow up with insurance payers through portals and phone communication (follow up on aging claims through payer portals, phone calls, and billing systems) – similar. 3. Review payer guidelines and submit claim appeals (submit timely and accurate appeals based on payer-specific guidelines and supporting documentation). 4. Manage aging reports and prioritize time-sensitive accounts. 5. Reprocess claims and update billing information within the EMR system (reprocess claims as needed; post adjustments, payments, and account updates accurately within the EMR system). 6. Collaborate with billing, coding, and operational teams to resolve claim issues (collaborate with internal billing, coding, and operational teams to reduce recurring denials and reimbursement delays). 7. Manage multiple claims simultaneously while maintaining productivity and accuracy standards (support departmental productivity, quality, and turnaround time expectations). 8. Review claim edits, rejections, and payment discrepancies to determine resolution steps. 9. Perform insurance re-verification. 10. Maintain detailed documentation regarding claim follow-up activity and payer communication. We'll keep all. Now Requirements/Education & Experience: - High school diploma or equivalent required. - 2+ years of experience in medical billing, insurance follow-up, denial resolution, claims management, or healthcare revenue cycle operations required. - Prior experience with surgical, specialty practice, outpatient, or procedural billing strongly preferred. - Familiarity with Centricity / Athena EMR preferred. - Experience reviewing appeals, denials, EOBs, and payer correspondence strongly preferred. Also "This Role Is Great For Candidates With Experience In:" list: Medical Billing, Claims Resolution, Insurance Follow-Up, Denial Management, Accounts Receivable (AR), Revenue Cycle Management, Healthcare Billing, Payer Appeals, Medical Collections, Specialty Medical Billing, Surgical Billing, Healthcare Administration. We could treat that as Skills or maybe as additional qualifications. Now "What You’ll Bring" list: - Ability to work independently and maintain productivity in a fully remote environment - Strong understanding of medical billing, claims follow-up, denial management, and insurance workflows - Knowledge of CPT, ICD-10, EOBs, payer guidelines, and medical billing terminology - Comfortable navigating payer portals, EMR systems, and healthcare billing platforms - Strong analytical and problem-solving skills with attention to detail - Ability to manage multiple claims and deadlines within a fast-paced environment - Clear written and verbal communication skills when working with payers and internal teams - Organized, self-motivated, and accountable work style Now 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 Now Schedule & Location: - Fully remote position - Standard business hours Monday–Friday - Candidates must have reliable internet access and a distraction-free remote work environment Now we need to output HTML with headings for sections that have content. We need to decide which headings to use: About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Schedule. Possibly also "Preferred Qualifications" but not needed. We must not include Pay section. We need to avoid duplication: we have Requirements (education/experience) and Qualifications (maybe preferred experience) and Skills (What You’ll Bring). Could combine Requirements and Qualifications into one section? But instruction: Prefer a few substantive sections over many thin ones. So we could merge Education & Experience and Preferred Experience into a "Requirements" section, and Skills into a "Skills" section. Or we could have "Requirements" for mandatory, "Preferred Qualifications" for preferred, and "Skills" for abilities. That's three sections, still okay. But we need to ensure we don't create thin sections with little content. Each will have decent list. Let's plan:About the role
... (company intro + role description)
Responsibilities
- ... list ...
Requirements
- ... mandatory: high school diploma, 2+ years experience ...
Preferred Qualifications
- ... prior experience with surgical/specialty practice..., familiarity with Centricity/Athena EMR, experience reviewing appeals, denials, EOBs, payer correspondence ...
Skills
- ... ability to work independently..., strong understanding..., knowledge..., comfortable navigating..., strong analytical..., ability to manage multiple claims..., clear communication..., organized self-motivated ...
Benefits
- ... benefits list ...
Schedule
- ... fully remote, standard business hours Monday–Friday, reliable internet, distraction-free environment ...