Claims Research & Resolution Representative

This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Claims Research & Resolution Representative based in United States.

This role sits at the center of claims operations, where accuracy, investigation, and member support directly shape outcomes for customers and providers. You will handle complex claim inquiries involving research, validation, and resolution across a variety of healthcare scenarios. The position requires strong analytical thinking, attention to detail, and the ability to interpret policies and procedures with confidence. You will collaborate with insurance partners, providers, and members to resolve disputes and ensure timely settlements. Working in a structured yet fast-paced environment, you will exercise independent judgment while maintaining compliance with regulatory and confidentiality standards. This is a highly impactful role where your decisions help ensure fair, accurate, and efficient claims processing.

This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Claims Research & Resolution Representative based in United States.

This role sits at the center of claims operations, where accuracy, investigation, and member support directly shape outcomes for customers and providers. You will handle complex claim inquiries involving research, validation, and resolution across a variety of healthcare scenarios. The position requires strong analytical thinking, attention to detail, and the ability to interpret policies and procedures with confidence. You will collaborate with insurance partners, providers, and members to resolve disputes and ensure timely settlements. Working in a structured yet fast-paced environment, you will exercise independent judgment while maintaining compliance with regulatory and confidentiality standards. This is a highly impactful role where your decisions help ensure fair, accurate, and efficient claims processing.

We use an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. Our system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company. The final decision and next steps (interviews, assessments) are managed by their internal team.

We appreciate your interest and wish you the best!

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