Claims Operations Specialist

Quartz Health Solutions; Wisconsin; Hybrid; USD 32,000 - 40,000; Full time

Benefits offered by this job

Flexible work environment

Remote/hybrid/full-time options

Competitive pay & rewards

Job summary

Quartz Health Solutions is seeking a Claims Operations Specialist to review and resolve a variety of claims, reports, and pended items. You’ll investigate details, collaborate with providers, members, and internal partners, and help adjudicate claims accurately and timely.

This full-time role offers flexible work arrangements (remote, hybrid, or in-person) and a competitive pay range. Strong attention to detail, problem-solving, and proficient computer skills are essential to support quality

Qualifications

• 3+ years of experience in medical or dental claims processing.
• Strong computer skills including Microsoft Office products and Windows.
• Attention to detail and commitment to continuous quality improvement.

Responsibilities

• Review and resolve a variety of claims-related items and reports.
• Correspond with providers, members, and internal partners to gather information and adjudicate claims.
• Identify trends and opportunities for process improvements, including changes to the Claims Manual.

Skills

Claims processing experience

Attention to detail

Problem solving

Communication

Education

High school diploma or equivalency

Tools

Microsoft Office

Microsoft Windows

Job description

Looking to start or grow your career in healthcare? Join Quartz as a Claims Operations Specialist and play an essential role in ensuring our members receive accurate and timely claims processing. In this position, you’ll work within our claims processing system to review and resolve a variety of claims, reports, and pended items. You’ll investigate details, identify solutions, and help ensure everything is handled correctly—because behind every claim is a real person counting on us to get it right.

This role is more than processing paperwork. You’ll collaborate with providers, members, and internal partners to gather information, answer questions, and move claims forward. Your attention to detail, curiosity, and problem-solving skills will be key in delivering a smooth and positive experience.

If you enjoy working with information, solving puzzles, and being part of a team that keeps things running smoothly, this is a great opportunity to build valuable skills in a growing industry.

At Quartz, we’ll help you succeed with hands‑on training, ongoing support, and opportunities to expand your knowledge and advance your career—all within a welcoming, inclusive environment.

Come find your spark at Quartz—and discover how your work can make a meaningful difference every day.

Benefits

• Flexible and supportive work environment
• Full-time,remote,in-person or hybridwork environments available
• Pay range between at $23.03 - $28.75/hour, plus robust total rewards package

Responsibilities

• Review and resolve a variety of claims-related items and reports—including more complex cases—using our claims processing system.
• Correspond with providers, members, and internal partners to gather information needed to adjudicate claims appropriately and timely
• Identify trends and opportunities for process improvements, including changes needed to the Claims Manual

Qualifications

• High school diploma or equivalency
• 3+ years of experience in medical or dental claims processing
• Strong computer skills, including familiarity with Microsoft Office products and Microsoft Windows operating systems
• Strong attention to detail and adherence to the principles of continuous quality improvement to ensure that our members receive the highest quality service
• Ability to complete tasks on short deadlines – ensuring timely follow up and attention to work assignments

Hardware and equipment will be provided by the company, but candidates must have access to high-speed, non-satellite Internet to successfully work from home.

Quartz offers an excellent benefit and compensation package, opportunity for professional growth and a professional culture built upon the foundations of Respect, Responsibility, Relationships, & Resourcefulness. To support a safe work environment, all employment offers are contingent upon successful completion of a pre-employment criminal background check.

Quartz values and embraces diversity and is proud to be an Equal Employment Opportunity, Aff

All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex, gender identity or expression, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified person with disability.