Claims Resolution Specialist

The Midtown Group is teaming up with a leading technology company to support a D.C. government department that offers its residents a Medicaid program. Our collective goal is to modernize and optimize DC's Medicaid program while offering outstanding customer support. Our venture is focused on improving outcomes, enhancing provider experiences, and safeguarding program integrity. For this project, our partner will provide technology, and we will provide people and expertise across several functions, including contact center operations.Claims Resolution Support Specialists will support D.C. medical providers who need assistance with Medicaid benefits.These positions are in-person, located in Downtown D.C. There are no plans to move to hybrid or fully remote models. Interviews begin on Thursday, 12/18/25, and these engagements are expected to start on 1/26/26 and may continue for up to two or three years or longer.Duties:Review and research claims based on claims processing guidelines.Refer claims to the appropriate department.Prepare Return to Provider (RTP) forms as necessary when required claim information is missing or invalid.Self-motivated with good time management and organization skills.Ability to work with several different teams, tasks, and completing deadlines to ensure all work is completed accurately.Other duties as assignedRequirements:Bachelor’s degree or equivalent work experience or combination of education and experience.A minimum of 2 years of previous experience for a government or private sector inbound customer service center (Preferred)Knowledge of basic help desk software, computer software and Microsoft Office applications.Strong problem-solving skills to bring inquiries to effective resolution.Strong customer service skills with an emphasis on written and oral communication to respond to inquiries professionally.Ability to identify the correct stakeholders to consult to resolve client inquiries.Medicaid and/or medical claims experience strongly preferred.Schedule Requirements:Hours of Operation: Within the hours of 7:45 AM –5:15 PM, Eastern Time, Monday - Friday, candidate must be able to work any assigned 8-hour shift between these hours.The Midtown Group is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran. We are a small, woman-owned business certified by the Women’s Business Enterprise National Council (WBENC). Operating from our headquarters in Washington, DC, we provide trusted staffing services nationwide. Our clients include thousands of the most prestigious Fortune 500 companies, law firms, financial organizations, tech innovators, non-profits, and lobbying firms, as well as federal, state and local government agencies.Company DescriptionOur client's infrastructure is collaborative and provides opportunities for growth!

Salary : $24 - $27