Adjudication Edit Clerk- Roseville, CA

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
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. Gainwell empowers you to help clients deliver better health and human services outcomes using innovative technology and solutions, enabling you to design your career for growth, new possibilities, and refinement of your valuable skills. 

Your Role in Our Mission

• Review Medi-Cal dental treatment authorization request (TAR) and claim submissions for completion and compliance with policies and procedures.

• Update TAR/claim information, such as provider number and/or member information.

• Send Resubmission Turnaround Documents (RTDs) to dental providers to correct mistakes and/or provide additional information.

• Support dental consultants and paraprofessionals in the process of adjudication.

What We're Looking For

• A minimum of two (2) years of prior experience in a dental billing or claims processing environment.

• Expertise to support TAR/claim adjudication.

• Strong communication skills (oral and written).

• Strong typing skills.

What You Should Expect in This Role

• Must be a resident of the state of California.

• Hybrid work environment: two days a week in the office, with the remainder of time remote. The office is located in the Roseville/Sacramento area.

The pay range for this position is $41,100.00 - $58,700.00 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.