Healthcare Claims Resolution Specialist - Tucker, GA (Hybrid)

Gainwell Technologies LLC•Tucker, GA

6d•$30,500 - $43,500•Hybrid

About The Position

As a Healthcare Claims Resolutions Specialist at Gainwell, 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.

Requirements

High School Diploma or GED.
Minimum of 2 years of experience in customer service or claims processing, or a related field.
Intermediate understanding of Microsoft Office products.
Demonstrated ability to work independently as well as collaboratively within a team environment.
Excellent verbal and written communication skills, with the ability to convey information clearly and effectively.
Proficiency in using a computer to access, retrieve, and manage information.
Strong organizational skills with the ability to prioritize tasks and manage workloads efficiently.
Analytical and problem-solving skills to address challenges and develop effective solutions.
A strong work ethic paired with effective time management abilities.
Proficiency in Microsoft Office Suite (e.g., Word, Excel, Outlook, and PowerPoint).
Willingness to participate in meetings as needed to support team and organizational goals.
Broadband internet connection with a minimum speed of 24 Mbps download and 8 Mbps upload.

Responsibilities

Utilize various system data bases in order to appropriately adjudicate a suspended claim.
Respond to emails quickly and precisely.
Review and research suspended Medicaid claims and adjudicate them per DCH policy.
Adhere to strict guidelines including HIPAA, company security, and company ethics.