Claims Examiner, Sr. Assistant Remote U.S.

Gainwell Technologies LLC•Any city, OH

11d•$30,500 - $43,500•Remote

About The Position

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. Gainwell Technologies is responsible for Claims Operations and Management functions supporting Federal and State Medical Assistance Services programs. As a Claims Resolution Analyst, you will play a key role in researching, resolving, and processing provider claims while ensuring accuracy, compliance, and exceptional customer support.

Requirements

Experience in healthcare insurance, medical claims processing, claims resolution, or a related healthcare operations environment.
Strong attention to detail, analytical thinking, and problem-solving skills.
Ability to multitask, prioritize work, and meet deadlines in a fast-paced environment.
Proficiency with Microsoft Office applications and the ability to navigate multiple systems to research and process claims.
Strong written and verbal communication skills, along with the ability to interpret policies, procedures, and operational guidelines.

Responsibilities

Review, research, and resolve medical and dental claims in accordance with established processing guidelines and procedures.
Analyze claims issues and collaborate with internal departments to ensure timely and accurate resolution.
Manage multiple priorities while maintaining productivity, accuracy, and service-level expectations.
Communicate claim status, workload updates, and potential issues to leadership and business partners as appropriate.