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Operations CIF Specialist- Roseville, CA

Date:  Feb 20, 2024
Location: 

Roseville, CA, US, 95747-6645

Req ID:  21154

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 an Operation CIF Specialist 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.

Your role in our mission

  • Process Claim Inquiry Form (CIF), monitor system edits and history cross-check functionality, resolve dental procedure edits, and verify the appropriateness of proposed treatments according to the California Medi-Cal Dental program guidelines.
  • Research and evaluate the status of Claims submitted for payment and process reevaluation requests for denials or modification of original requested services.
  • Analyzes and evaluates both production and processing output results to identify errors and inconsistencies.
  • Works with and consults with leadership and clients to review and evaluate inconsistent and erroneous output results.
  • Evaluate program policy changes and identify potential adverse impact(s) on systems and operations

What we're looking for

  • Two years of college preferred or equivalent combination of education and experience.
  • Analytical skills necessary to effectively evaluate operations test results.
  • Ability to communicate effectively, both orally and in writing, and work cooperatively with others; ability to work independently as well as collaboratively.
  • Two years of full-time experience supporting Claim Inquiry Forms (CIF) on the Medi-Cal Dental program in California.
  • Ability to maintain confidentiality.

What you should expect in this role

  • Must be a resident of the state of California.
  • Hybrid work environment 3 days a week in the office as needed for face-to-face and client meetings with the remainder of the time remote work.  
  • Our office is located in Roseville, CA.

 

The pay range for this position is $69,100.00 - $98,700.00 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.

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