Claims Resolution Specialist - Remote PA

Date: Oct 1, 2024

Location:

Madison, WI, US, 53784-0001

Req ID: 26506

It takes great medical minds to create powerful solutions that solve some of healthcare’s most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you’ve honed your career in a fast-moving medical environment. While Gainwell operates with a sense of urgency, you’ll have the opportunity to work more flexible hours. And working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values work-life balance, continuous learning, and career development.

Summary

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 Technologies offers incredible opportunities to grow your career in a company that values your contributions, emphasizes work flexibility, and prioritizes learning and career development.

Gainwell Technologies is responsible for all Claims Operation and Management functions of Medical Assistance Services. The primary role of a Claims Resolution Specialist is to provide exceptional customer support for incoming and outgoing Provider Claims processing.

Your role in our mission

Help create the power in Gainwell’s processes as we develop purpose-built technologies and solutions that yield better health and human services outcomes.

Review and research claims based on claims processing guidelines.
Refer claims to the appropriate department when necessary.
Prepare Return to Provider (RTP) forms when required claim information is missing or invalid.
Provide internal leadership with a clear understanding of workload status and potential roadblocks.
Collaborate with various teams to meet deadlines and ensure work is completed accurately.
Self-motivated with strong time management and organizational skills.

What we're looking for

Attention to detail and commitment to accuracy.
Ability to multitask in a fast-paced environment.
Proficiency in Microsoft Office Suite and data entry skills.
Strong oral and written communication skills.
Knowledge of the Julian calendar is preferred.
Experience working with healthcare insurance and/or medical claims.

What you should expect in this role

Strong analytical and problem-solving skills.
Interpersonal skills to collaborate effectively with team members.
Excellent communication skills to engage with clients professionally.
Ability to maintain confidentiality and handle sensitive information.
Adaptability and flexibility to handle changing tasks and priorities.
Full-time work schedule: Monday through Friday, 8 AM to 5 PM.

#LI-REMOTE

#LI-JT1

#LI-CM1

The pay range for this position is $30,500.00 - $43,500.00 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.