Medical Insurance Claims Specialist

We are looking for a Medical Insurance Claims Specialist to join a growing revenue cycle team in Durham, North Carolina. This contract-to-permanent opportunity is ideal for someone who thrives in a complex claims environment, can work independently, and is motivated to resolve payer-related issues with persistence and sound judgment. The role supports specialized insurance and billing operations, requiring close attention to payer guidelines, regional differences, and accurate claim follow-up. This position offers strong training, career growth potential, and a hybrid schedule with onsite work Monday through Wednesday.

Responsibilities:
• Manage medical insurance claims across an assigned group of states, taking ownership of payer follow-up and resolution activities within your region.
• Review and address claim issues by interpreting payer requirements, identifying coverage or billing discrepancies, and pursuing appropriate next steps for reimbursement.
• Verify patient and insurance eligibility details to support accurate claim submission and reduce avoidable denials.
• Post payments and reconcile billing activity while maintaining accuracy in documentation and account updates.
• Communicate with insurance carriers to clarify claim status, provide needed education on specialized services, and advocate for proper claim handling.
• Partner with billing and collections team members, supervisors, and managers to resolve complex accounts and improve reimbursement outcomes.
• Maintain organized records of claim actions, payer responses, and follow-up efforts in accordance with internal standards.
• Contribute to a high-accountability team environment by managing daily work consistently, meeting attendance expectations, and taking full ownership of assigned responsibilities.

Qualifications:

• Experience working with medical claims, insurance claims, or medical billing in a healthcare revenue cycle setting.
• Knowledge of patient eligibility verification and insurance eligibility processes.
• Ability to navigate complex payer guidelines and adjust approach based on state-specific or payer-specific requirements.
• Strong problem-solving skills with the initiative to investigate difficult claim scenarios and pursue resolution independently.
• Dependable work habits, including consistent attendance, punctuality, and the ability to manage a full workday effectively.
• Comfort working in a specialized, fast-paced environment where priorities may shift and teamwork is essential.
• Clear communication skills for interacting with payers and collaborating across billing, insurance, and collections functions.

Compensation

$20.00-$23.00 Hourly

About Us

Robert Half is the world’s first and largest specialized talent solutions firm that connects highly qualified job seekers to opportunities at great companies. We offer contract, temporary and permanent placement solutions for finance and accounting, technology, marketing and creative, legal, and administrative and customer support roles.

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All applicants applying for U.S. job openings must be legally authorized to work in the United States. Benefits are available to contract/temporary professionals, including medical, vision, dental, and life and disability insurance. Hired contract/temporary professionals are also eligible to enroll in our company 401(k) plan. Visit roberthalf.gobenefits.net for more information.

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