Claims Specialist- Anchorage, AK

Gainwell Technologies LLC•Anchorage, AK

8d•$37,500 - $53,500•Hybrid

About The Position

Be part of a team that unleashes the power of leading-edge technologies to help improve the health and well-being of those most vulnerable in our country and communities. Working at HMS, a Gainwell Company carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values work flexibility, learning, and career development. You’ll add to your technical credentials and certifications while enjoying a generous, flexible vacation policy and educational assistance. We also have comprehensive leadership and technical development academies to help build your skills and capabilities. SummaryHMS is hiring Claims Specialists to support our Alaska account. These positions processes moderately complex claims for our Alaska Medicaid client. They will make decisions on payment of medical claims using the existing policy and rules to ensure accurate and timely completion.Your role in our mission Ability to work both independently and as part of a team. Strong communication skills with the ability to communicate clearly and effectively in writing and verbally. Ability to access and retrieve information using a PC. Intermediate understanding of Microsoft Office products. Organizational skills to balance and prioritize work, and analytical and problem-solving skills. What we're looking for Review and research suspended medical claims and adjudicate them per DHS policy. Refer claims to Utilization Review and Provider Services units. Maintain necessary documentation. Participate in meetings as necessary. Participate in process improvement sessions. Train as a back-up for other areas, such as document control, courier, and customer service desk. Other duties as assigned What you should expect in this role Hybrid role with ability to work in the Anchorage, AK office preferred, with the possibility of working remotely from another state for the right candidate. The person will need to work Alaska Time hours.

Requirements

Ability to work both independently and as part of a team.
Strong communication skills with the ability to communicate clearly and effectively in writing and verbally.
Ability to access and retrieve information using a PC.
Intermediate understanding of Microsoft Office products.
Organizational skills to balance and prioritize work, and analytical and problem-solving skills.

Responsibilities

Review and research suspended medical claims and adjudicate them per DHS policy.
Refer claims to Utilization Review and Provider Services units.
Maintain necessary documentation.
Participate in meetings as necessary.
Participate in process improvement sessions.
Train as a back-up for other areas, such as document control, courier, and customer service desk.
Other duties as assigned