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The Claims Research & Resolution Professional 2 manages claims operations that involve customer contact, investigation, and settlement of claims for and against the organization. Approves all claim settlements both for and against the organization. The Claims Research & Resolution Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.

The Claims Research & Resolution Professional 2 works with providers, members, and internal and external payer partners in the settlement of claims. Supports a team that processes claims by researching the resolution to a claims issue inquiry. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance ...