Claims Examiner - Remote US

Gainwell Technologies LLC•Any city, OH

1d•$30,500 - $43,500•Remote

About The Position

Gainwell Technologies is hiring a full-time, remote U.S. Claims Examiner to support healthcare and insurance claims processing operations. The role involves reviewing, researching, and processing claims while ensuring accuracy, compliance with established policies and procedures, and timely resolution. It is suited to someone who enjoys problem-solving and working with detailed information.

Requirements

High school diploma or GED.
Two or more years of experience in insurance claims processing, healthcare operations, administrative support, or a related field.
Knowledge of insurance terminology, claims processing procedures, eligibility verification, and coverage requirements.
Strong analytical, organizational, and problem-solving skills, with excellent attention to detail and accuracy.
Proficiency with computer applications, data entry, and Microsoft Office, with the ability to navigate multiple systems and communicate effectively.

Nice To Haves

Additional education or training in healthcare administration, insurance, or a related field.

Responsibilities

Review, evaluate, and process insurance claims received electronically or through written documentation, ensuring accuracy and compliance with established policies and procedures.
Verify insurance eligibility, coverage information, policy details, and supporting documentation to determine appropriate claim processing and resolution.
Research claim discrepancies, investigate processing issues, and identify necessary corrections, adjustments, or additional information needed to resolve claims.
Respond to claim-related inquiries from customers, providers, and internal teams while maintaining accurate records and documentation.
Manage assigned claims workloads, meet established productivity and quality standards, and escalate complex claims or discrepancies requiring additional review or approval.