- Full Time
- US
- 45000-55000 USD / Year
NuStart Consulting
Join NuStart Consulting as a Claims Resolution Specialist and play a vital role in our healthcare claims operations across the United States. This full-time position focuses on identifying, investigating, and resolving complex Durable Medical Equipment (DME) claims to ensure accurate reimbursement and seamless payer relationships.
About the Role
As a Claims Resolution Specialist, you'll serve as a problem-solver in our claims management team, working with healthcare providers and insurance carriers to untangle billing complications and recover lost revenue. You'll dig into claim histories, uncover root causes of denials and delays, and implement lasting solutions that get providers paid correctly.
What You'll Do
- Analyze DME claims to pinpoint billing errors, coding mistakes, or insurance coverage gaps preventing timely payment
- Research claim histories across multiple payers to identify patterns and discrepancies
- Prepare detailed correction submissions and resubmit claims to the appropriate insurance carriers
- Collaborate with providers and payers to clarify coverage requirements and resolve claim disputes
- Document resolution actions and outcomes to improve future claims accuracy
- Track claim status through resolution and confirm successful reimbursement
- Communicate findings and next steps clearly to internal teams and external stakeholders
What We're Looking For
- Experience in healthcare claims processing, medical billing, or insurance claims resolution
- Familiarity with DME claims, billing codes, or payer policies
- Strong attention to detail and ability to identify discrepancies in complex documentation
- Excellent written and verbal communication skills
- Organized approach to managing multiple claims simultaneously
- Problem-solving mindset and persistence in resolving challenging cases
- Proficiency with claims management software and standard business applications
About NuStart Consulting
NuStart Consulting partners with healthcare providers nationwide to optimize revenue cycle management and resolve complex claims issues. Our team combines industry expertise with a commitment to helping providers achieve the reimbursement they've earned.
How to Apply
To apply, complete your application directly on this page, or you'll be redirected to the employer's application platform to finish submitting there.
To apply for this job please visit www.adzuna.com.
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The United States of America (USA), also known as the United States (U.S.) or America, is a country primarily located in North America. It is a federal republic consisting of 50 states and a federal capital district, Washington, D.C. The 48 contiguous states border Canada to the north and Mexico to the south, with the semi-exclave of Alaska in the northwest and the archipelago of Hawaii in the Pacific Ocean. The United States also asserts sovereignty over five major island territories and various uninhabited islands in Oceania and the Caribbean. It is a megadiverse country, with the world's th
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