Claims Resolution Analyst – Healthcare Revenue Cycle

Yale New Haven Health; New Haven (CT); On-site; USD 42,000 - 54,000; Full time

Job summary

Yale New Haven Health is seeking a Billing Specialist to manage third party claims, submit and correct information with payers, and monitor balance resolutions. The role emphasizes accuracy, timely submissions, and effective communication with payers and hospital departments.

The ideal candidate will have 1–2 years in third party claims/billing in a hospital revenue cycle, strong knowledge of payer rules, and proficiency in Microsoft Office.

Qualifications

• High school diploma required; Associate degree in business preferred.
• 1–2 years of third party claims management/billing experience in a hospital revenue cycle environment preferred, Epic experience a plus.
• Extensive knowledge of third party insurance carriers and their billing/reimbursement requirements.
• Excellent analytical and organizational skills with ability to work in a high-volume, fast-paced setting.
• Proficient communication (written and verbal) and strong computer skills (Microsoft Office).

Responsibilities

• Handles a high volume of third party claims and ensures accurate information is submitted to payers.
• Completes daily claims submission and resubmissions within department timelines.
• Follows up on paid and unpaid claims to expedite prompt payment.
• Performs duties to resolve inpatient and outpatient credit balances and posts adjustments as needed.
• Keeps abreast of federal, state, and insurance regulations and assists in process improvements.

Skills

Analytical skills

Organizational skills

Communication

Attention to detail

Microsoft Office

Education

High school diploma

Associate degree in business

Tools

Epic

Job description

Yale New Haven Health is seeking a Billing Specialist to manage third party claims, submit and correct information with payers, and monitor balance resolutions. The role emphasizes accuracy, timely submissions, and effective communication with payers and hospital departments.

The ideal candidate will have 1–2 years in third party claims/billing in a hospital revenue cycle, strong knowledge of payer rules, and proficiency in Microsoft Office.