Provider Services Associate Analyst - Remote US

Summary

We are seeking a talented individual for a Provider Services Analyst – Medicaid who provides on-site and remote account analysis for identifying and recovering client overpayments made to healthcare providers. Responsible for provider outreach and scheduling on-site reviews. Responsible for developing and managing Provider relationships, working independently to identify and secure Provider refunds. Explains audit policies and procedures to the provider; conducts exit conferences to review findings, and reschedules subsequent audits. Responsible for providing successful field and remote performance within assigned territory. 

Your role in our mission

• Conduct on-site and remote reviews of provider accounts to identify potential overpayments, billing discrepancies, and credit balances.
• Review provider Aged Trial Balance and Debit Adjustment reports to assist in selecting claims for audit.
• Communicate with provider personnel throughout the audit process and document findings accurately.
• Prepare credit balance worksheets, audit summaries, and supporting documentation for internal review.
• Assist with identifying recovery opportunities and supporting provider refund efforts.
• Maintain audit records and ensure compliance with client policies, procedures, and regulatory requirements.
• Collaborate with internal teams to resolve audit-related questions and support recovery initiatives.

What we're looking for

• 1–3 years of healthcare billing, accounts receivable, auditing, revenue cycle, or related experience preferred.
• Basic understanding of healthcare claims processing, provider billing practices, and reimbursement methodologies.
• Strong analytical, organizational, and problem-solving skills with attention to detail.
• Proficiency in Microsoft Excel and Word; ability to learn provider accounting systems and payer requirements.
• Ability to manage multiple assignments in a fast-paced environment while meeting established deadlines.
• Effective verbal and written communication skills with the ability to interact professionally with providers and internal stakeholders.
• Knowledge of HIPAA and healthcare compliance requirements preferred.
• Willingness to travel up to 25% and work additional hours as business needs require.

What you should expect in this role

• Remote within the United States.
• Video cameras must be used during all interviews, as well as during the initial week of orientation.
• To work effectively in a teleworker or hybrid position with Gainwell, employees must have a broadband internet connection with a minimum speed of 24 Mbps download and 8 Mbps upload. Higher speeds are recommended for optimal performance.
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