Claims Specialist

Gainwell Technologies LLC•Any city, OH

7d•$37,500 - $53,500•Hybrid

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. As Claims Specialist, 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. Help create the power in Gainwell’s processes as we develop purpose-built technologies and solutions that yield better health and human services outcomes.

Requirements

Knowledge of the fundamental concepts and principles in the medical and/or insurance fields
Basic reading and analysis skills to evaluate claims and make adjudication decisions
Basic computer use skills
Ability to multi-task across multiple claims to work efficiently
Ability to work independently to meet individual production goals

Responsibilities

Share your expertise as you support the Business Process Services team in claims processing that adheres to policy guidelines
Meet production and quality requirements established by clients for timely claims processing
Use policy guidelines and criteria established by leadership to evaluate why a claim errored and make an adjudication decision