Gainwell Technologies
Healthcare Insurance • Human Services • Healthcare
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.
Senior Healthcare Payment Analyst
Job not on LinkedIn
September 27
Gainwell Technologies
Healthcare Insurance • Human Services • Healthcare
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
• Develop and implement new data mining opportunities for identifying healthcare overpayments • Act as a senior member of the team and assist lower-level analysts • Research industry standard guidelines and develop improper payment algorithms • Review provider contracts to identify algorithms for overpayments • Support the appeals and validation teams in resolving issues • Document query results and prepare presentations related to overpayment issues • Collaborate with internal teams to develop and implement review protocols
🎯 Requirements
• 5+ years of experience in healthcare reimbursement, claims analysis, or revenue cycle improvement • Strong background in medical billing/coding, auditing, and provider contract development • Familiarity with CMS regulations, coding guidelines, and recovery audit practices • Ability to apply published healthcare guidelines to claims data
🏖️ Benefits
• generous, flexible vacation policy • educational assistance • comprehensive health benefits • 401(k) employer match • leadership and technical development academies
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