Senior Healthcare QA Representative

🕒 September 15

🏈 Ohio – Remote

🏈 Ohio – Remote

💵 $50.4k - $72k / year

⏰ Full Time

🟠 Senior

🔧 QA Engineer (Quality Assurance)

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

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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

• Perform quality assurance and audit activities across healthcare financial operations, including accounts receivable/payable, capitation, credit balances, cost settlements, recoveries, and related processes • Review financial transactions, healthcare data, reports, and supporting documentation to identify discrepancies and ensure accuracy and compliance with established controls • Use SQL to query, extract, review, and analyze data for audits, reporting, research, reconciliation, and operational analysis • Create, maintain, and update audit procedures, control documentation, operational processes, and client-required reporting • Research complex financial and operational issues • Recommend process improvements • Serve as a resource to team members on quality, audit, and operational requirements

🎯 Requirements

• Bachelor’s degree or equivalent combination of education and relevant professional experience in quality assurance, auditing, finance, accounting, financial analysis, or a related function • Healthcare industry experience, preferably within Medicaid, Medicare, managed care, health insurance, claims, or government healthcare programs • One to two years of hands-on SQL experience, including querying, extracting, reviewing, and analyzing data • Working knowledge of medical terminology • Experience interpreting healthcare-related data, claims, documentation, and operational information • Knowledge of financial controls and accounting principles, including GAAP and/or SOX • Strong analytical, research, problem-solving, and communication skills • Candidate must reside in the United States

🏖️ Benefits

• Comprehensive medical, dental, and vision coverage for eligible employees • 401(k) retirement savings plan • 401(k) employer match • Employee wellness benefits • Financial benefits • Paid time off • Paid holidays • Flexible vacation policy for salaried, full-time candidates • Professional development opportunities • Career growth opportunities • Educational assistance • Leadership and technical development academies • Flexible work hours • Remote work from home