Medical Claims Resolution Specialist

About the role

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. 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

Responsibilities

• 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

Requirements

• 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
• 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
• This Role Is Great For Candidates With Experience In:
• Medical Billing
• Claims Resolution
• Insurance Follow-Up
• Denial Management
• Accounts

Benefits

Additional Information

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 8 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. Medical Claims Resolution Specialist Healthy legs feel better. 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, 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.

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