[Hiring] Associate Business Process Services-Mailroom & Claims Team @Gainwell Technologies LLC

Role Description

As Associate Business Process Services-Mailroom & Claims Team, Nevada / Remote, you can contribute your skills as we harness the power of technology to help our clients improve the health and well-being of the members they serve — a community’s most vulnerable. Connect your passion with purpose, teaming with people who thrive on finding innovative solutions to some of healthcare’s biggest challenges.

• Adjudicate, research, and review complex claims and appeals
• Analyze trends and generate reports on claims and appeals activity
• Investigate and respond to claim appeals with well-supported decisions
• Represent and support appeal determinations in hearings and preparation meetings
• Ensure HIPAA compliance, maintain confidentiality, and provide team support as needed

Qualifications

• Strong verbal/written communication and literacy
• Knowledge of Microsoft products (Outlook, Word, Excel and TEAMS)
• Demonstrated ability to analyze information and think strategically
• High proficiency, with exceptional level of accuracy required
• Proven ability to work independently and as part of a team
• Claims processing or other experience in healthcare, health insurance or Medicaid is preferred

Requirements

• Fully remote role
• Standard schedule: Monday–Friday, 8 hours per day
• Flexible start times between 7:00–8:00 AM based on workload
• Occasional overtime may be required, though infrequent
• Limited travel may be needed to attend and represent at Fair Hearings

Benefits

• Generous, flexible vacation policy
• 401(k) employer match
• Comprehensive health benefits
• Educational assistance
• Variety of leadership and technical development academies to help build your skills and capabilities