Provider Services Associate Analyst - Remote US

Gainwell Technologies LLC•Any city, OH

1d•$38,600 - $55,100•Remote

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. 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

1–3 years of healthcare billing, accounts receivable, auditing, revenue cycle, or related experience preferred.
Basic understanding of healthcare claims processing, provider billing practices, and reimbursement methodologies.
Strong analytical, organizational, and problem-solving skills with attention to detail.
Proficiency in Microsoft Excel and Word; ability to learn provider accounting systems and payer requirements.
Ability to manage multiple assignments in a fast-paced environment while meeting established deadlines.
Effective verbal and written communication skills with the ability to interact professionally with providers and internal stakeholders.
Knowledge of HIPAA and healthcare compliance requirements preferred.
Willingness to travel up to 25% and work additional hours as business needs require.
Remote within the United States.
Video cameras must be used during all interviews, as well as during the initial week of orientation.
To work effectively in a teleworker or hybrid position with Gainwell, employees must have a broadband internet connection with a minimum speed of 24 Mbps download and 8 Mbps upload. Higher speeds are recommended for optimal performance.

Responsibilities

Conduct on-site and remote reviews of provider accounts to identify potential overpayments, billing discrepancies, and credit balances.
Review provider Aged Trial Balance and Debit Adjustment reports to assist in selecting claims for audit.
Communicate with provider personnel throughout the audit process and document findings accurately.
Prepare credit balance worksheets, audit summaries, and supporting documentation for internal review.
Assist with identifying recovery opportunities and supporting provider refund efforts.
Maintain audit records and ensure compliance with client policies, procedures, and regulatory requirements.
Collaborate with internal teams to resolve audit-related questions and support recovery initiatives.