Senior Provider Services Analyst - Remote US

Gainwell Technologies LLC•Any city, OH

18h•$64,500 - $92,200•Remote

About The Position

We are seeking a talented individual for a Provider Services Analyst – Medicaid who provides on-site and remote account analysis for identifying and recovering client overpayments made to healthcare providers. Responsible for provider outreach and scheduling on-site reviews. Responsible for developing and managing Provider relationships, working independently to identify and secure Provider refunds. Explains audit policies and procedures to the provider; conducts exit conferences to review findings, and reschedules subsequent audits. Responsible for providing successful field and remote performance within assigned territory.

Requirements

5+ years of healthcare billing, audit, or AR experience preferred; strong analytical and problem-solving skills.
Proficient in Microsoft Word and Excel; quick to learn provider AR systems and payer standards.
Able to manage multiple priorities independently under tight deadlines.
Detail-oriented, adaptable to changing regulations, and committed to quality and compliance(e.g., HIPAA).
Willingness to travel up to 25% and work extended hours as needed.

Responsibilities

Conducts on-site and remote financial account analysis to identify overpayments, discrepancies, and billing errors.
Reviews provider Aged Trial Balance and Debit Adjustment reports to select claims for audit.
Communicates with provider personnel throughout the audit process and delivers summary reports.
Identifies refund trends and recommends data mining opportunities to optimize revenue.
Prepares and shares credit balance worksheets and audit findings with providers and internal teams.