Resolution Specialist I

LOCAL CANDIDATES ONLY

Overview
Research Data Group’s Beacon HCI division provides nationwide cost-containment solutions, ensuring every healthcare claim is accurate, compliant, and aligned with billing and regulatory standards. The Resolution Specialist secures refunds from hospitals and providers, supporting timely recovery and fiduciary integrity for our clients.

The Beacon HCI division is seeking a detail-orientedLevel I Resolution Specialist to assist with healthcare claim overpayment recovery. This position works with providers, facilities, payers, and TPAs to obtain refunds and resolve outstanding claims.

Key Responsibilities

• Create and submit healthcare refund requests
• Contact healthcare facilities to identify billing or refund contacts
• Send refund requests and perform consistent follow-up via phone, fax, and email
• Make outbound calls to providers and facilities for status and follow-up
• Accurately document all communication and updates in internal systems.
• Maintain and update the facility and provider contact information.
• Collaborate with the Resolution Manager on complex or escalated claims.
• Assist with special projects and process improvements.
• Adhere to HIPAA and company data security standards.

Skills & Qualifications

• Exceptional attention to detail and documentation accuracy
• Strong organization and attention to detail skills
• Strong verbal and written communication skills
• Ability to manage multiple priorities in a fast-paced setting
• Intermediate to Advanced Proficiency with Microsoft Office applications (Excel, Outlook, Word, and Teams)
• Minimum 2 years’ experience in healthcare billing, claims, revenue cycle, collections, appeals, or reimbursement recovery
• Minimum 2 years in a call-center environment
• Knowledge of CMS regulations, UB-04 claim forms, or refund recovery processes a plus
• Familiarity with payer networks or stop-loss claims a plus.