Claims Research Analyst - Little Rock, AR

Date: Jan 13, 2025

Location:

Little Rock, AR, US, 72201-4608

Req ID: 28563

Great companies need great teams to propel their operations. Join the group that solves business challenges and enhances the way we work and grow. Working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values your contributions and puts a premium on work flexibility, learning, and career development.

Summary

As a Claims Research Analyst - Little Rock, AR at Gainwell, 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. Here are the details on this position.

Your role in our mission

Conducts correspondence related to client requests for information.
Evaluates available information to validate claims. Verifies policyholder information, policy effective dates, premium status and verification of claim eligibility.
Identifies need for additional information; contacts appropriate source to obtain needed information. Verifies beneficiary or claimant information if claim is warranted. Identifies payment amount and obtains required management approvals for payment. Processes payment.
Investigates moderate to highly complex claims and determines level or resolution if appropriate; advises claimant of status; assists in negotiating settlement and resolution of claim.
Receives demand letters; researches and investigates claims, responds within individual parameters and escalates as appropriate.

What we're looking for

1-2 years of experience in claims processing, insurance, healthcare, or related fields.
Experience in data analysis is a plus.
Proficiency in claims processing systems and software (e.g., CMS-1500, UB-04).
Strong Microsoft Excel skills, including pivot tables, and formulas.
Capable of interpreting insurance policies, coding standards (e.g., CPT, ICD-10), and billing regulations.

What you should expect in this role

This is an onsite position in Little Rock, AR
Work schedule is Monday to Friday, from 8:00 AM to 4:30 PM
Video cameras must be used during all interviews, as well as during the initial week of orientation.

#LI-ONSITE #LI-JA1 #LI-CM1

The pay range for this position is $32,700.00 - $46,700.00 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. Put your passion to work at Gainwell. You’ll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits, and educational assistance. We also have a variety of leadership and technical development academies to help build your skills and capabilities.

We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Build your career with Gainwell, an industry leader. You’ll be joining a company where collaboration, innovation, and inclusion fuel our growth. Learn more about Gainwell at our company website and visit our Careers site for all available job role openings.

Gainwell Technologies is committed to a diverse, equitable, and inclusive workplace. We are proud to be an Equal Opportunity Employer, where all qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical condition), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. We celebrate diversity and are dedicated to creating an inclusive environment for all employees.