Remote Claims Resolution Specialist II

University of Rochester; City of Rochester (NY); Hybrid; USD 41,000 - 55,000; Full time

Job summary

The University of Rochester is seeking a Claims Resolution Representative II to support the professional fee organization, performing routine follow-up to bring open accounts receivable to closure and pursuing timely resolution of claims.

You will research, correct, resubmit claims, submit appeals, and communicate with providers, staff, and payors to maximize revenue and ensure accurate billing. This role requires teamwork, accuracy, and attention to evolving billing requirements.

Qualifications

• High School Diploma. 2 years of related work experience preferred.
• Strong working knowledge of professional billing software applications.
• Excellent customer service skills.

Responsibilities

• Follow department policies and use billing knowledge to resolve unpaid receivables.
• Follow up on denied accounts by reviewing remittances, EOBs, and claims submissions to ensure resolution.
• Respond to billing inquiries from colleagues, patients, and payors in a timely and professional manner.
• Keep management informed of trends and changes in billing requirements and claim processing.
• Escalate issues that may prevent completion of responsibilities to management.
• May perform other duties as assigned.

Skills

Billing software

Customer service

Education

High School Diploma

Job description

The University of Rochester is seeking a Claims Resolution Representative II to support the professional fee organization, performing routine follow-up to bring open accounts receivable to closure and pursuing timely resolution of claims.

You will research, correct, resubmit claims, submit appeals, and communicate with providers, staff, and payors to maximize revenue and ensure accurate billing. This role requires teamwork, accuracy, and attention to evolving billing requirements.