Healthcare Claims Resolution Specialist

Yale New Haven Health; New Haven (CT); On-site; USD 42,000 - 64,000; Full time

Job summary

Yale New Haven Health in New Haven, CT is seeking a detail‑oriented Medical Billing Specialist to manage third‑party claims and ensure accurate submissions to payers. You will monitor reimbursement timelines, resolve denials, and maintain clear documentation across the revenue cycle.

The ideal candidate has 1–2 years in a hospital revenue cycle environment (Epic preferred), strong analytical and communication skills, and proficiency with MS Office and payer portals to support prompt payments.

Qualifications

• High school diploma or equivalent; associate degree preferred.
• 1–2 years of third party claims management or hospital revenue cycle experience.
• Experience with payer websites and coding/billing systems is a plus.
• Proficient in MS Office and able to navigate multiple applications.
• Understanding of claims submission, denials, and payment workflows.

Responsibilities

• Handle a high volume of third party claims; submit to payers via clearing house or intermediary.
• Resubmit with updates; resolve payer rejections and report trends to supervisor.
• Follow up on paid/unpaid claims to expedite payment; document activities clearly.
• Post adjustments to maintain account integrity and address inpatient/outpatient balances.
• Stay current on federal/state/insurance regulations and payer guidelines.
• Perform additional duties as needed and participate in team initiatives.

Skills

Third party claims knowledge

Billing & reimbursement

Analytical skills

Organizational skills

Written & verbal communication

MS Office

Payer portals navigation

Education

High school diploma

Associate Degree in business related field

Tools

Epic

Job description

Yale New Haven Health in New Haven, CT is seeking a detail‑oriented Medical Billing Specialist to manage third‑party claims and ensure accurate submissions to payers. You will monitor reimbursement timelines, resolve denials, and maintain clear documentation across the revenue cycle.

The ideal candidate has 1–2 years in a hospital revenue cycle environment (Epic preferred), strong analytical and communication skills, and proficiency with MS Office and payer portals to support prompt payments.