COB Claims Auditor, Associate

Gainwell Technologies LLC • OH

86d • $35,000 - $50,000

About The Position

As a COB Claims Auditor, Associate at Gainwell, you’ll apply your attention to detail and analytical skills to ensure claims are accurate, compliant, and processed according to policy and regulatory standards. By auditing claim files, verifying payment accuracy, and identifying discrepancies, you’ll help safeguard the integrity of our claims process and contribute to our mission of delivering quality outcomes for the communities we serve. In this role, you’ll collaborate closely with management and the claims processing team, ensuring compliance with company procedures and state/federal regulations.

Responsibilities

• Review and verify insurance claims for accuracy and compliance with policy terms
• Audit claim files and analyze claim payment accuracy
• Examine complex claims to determine the legitimacy of the claim
• Identify inconsistencies or discrepancies in claims and report them to the appropriate departments
• Ensure that claim payments are made in accordance with company procedures and guidelines
• Work closely with management and the claims processing team to resolve claim issues
• Maintain updated knowledge of state and federal regulations regarding insurance claims
• Prepare reports detailing audit findings and recommendations

Benefits

• Generous, flexible vacation policy
• 401(k) employer match
• Comprehensive health benefits
• Educational assistance
• Leadership and technical development academies

What This Job Offers

• Job Type: Full-time
• Number of Employees: 5,001-10,000 employees