Medical Claims Resolution Analyst

🕒 6 days ago

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Gainwell Technologies

10,000+ employees

💼 Consulting

📦 Logistics

⚕️ Healthcare Insurance

💰 Grant on 2023-06

Consulting • Logistics • Healthcare Insurance

Gainwell Technologies is the nation’s leading provider of digital and cloud-enabled solutions across the human services and public health ecosystem. With a mission-driven approach, Gainwell serves clients in all 50 U. S. states, focusing on improving health outcomes and delivering intuitive, human-centered experiences. Their comprehensive suite of solutions includes Medicaid Enterprise modernization, data analytics, provider services, and pharmacy solutions, all designed to advance the future of healthcare and enhance community well-being.

📋 Description

• Help create the power in Gainwell’s processes as we develop purpose-built technologies and solutions that yield better health and human services outcomes • Support the Business Process Services team in claims processing that adheres to policy guidelines • Meet production and quality requirements established by clients for timely claims processing • Use policy guidelines and criteria established by leadership to evaluate why a claim errored and make an adjudication decision

🎯 Requirements

• Knowledge of the fundamental concepts and principles in the medical and/or insurance fields • Basic reading and analysis skills to evaluate claims and make adjudication decisions • Basic computer use skills • Ability to multi-task across multiple claims to work efficiently • Ability to work independently to meet individual production goals

🏖️ Benefits

• generous, flexible vacation policy • educational assistance • comprehensive health benefits • 401(k) employer match • comprehensive leadership and technical development academies

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