Claims Examiner

🔥 53 minutes ago

🧀 Wisconsin – Remote

🧀 Wisconsin – Remote

💵 $30.5k - $43.5k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

📋 Claims Specialist

🚫👨‍🎓 No degree required

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 0%

What it means: the chance that no one is really hiring for this job.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.Why this score:

• Just posted.
• Jobs at this company usually fill in 22 days.

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Gainwell Technologies

WebsiteLinkedInAll Job Openings

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

• Review, evaluate, and process insurance claims received electronically or through written documentation • Verify insurance eligibility, coverage information, policy details, and supporting documentation • Research claim discrepancies and investigate processing issues • Identify necessary corrections, adjustments, or additional information needed to resolve claims • Respond to claim-related inquiries from customers, providers, and internal teams • Maintain accurate records and documentation • Manage assigned claims workloads and meet productivity and quality standards • Escalate complex claims or discrepancies requiring additional review or approval

🎯 Requirements

• High school diploma or GED required • Additional education or training in healthcare administration, insurance, or a related field preferred • Two or more years of experience in insurance claims processing, healthcare operations, administrative support, or a related field • Knowledge of insurance terminology, claims processing procedures, eligibility verification, and coverage requirements • Strong analytical, organizational, and problem-solving skills • Excellent attention to detail and accuracy • Proficiency with computer applications, data entry, and Microsoft Office • Ability to navigate multiple systems and communicate effectively

🏖️ Benefits

• Flexible hours and work flexibility • Work-life balance • Continuous learning and career development • Medical, dental, and vision coverage • 401(k) with company matching eligibility after 90 days • Paid holidays, including floating holidays • Professional development opportunities through Gainwell University • Generous, flexible vacation policy • Educational assistance • Leadership and technical development academies

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