Summary As Provider Enrollment Analyst - Remote US, 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 mos…
Skills: Claims Processing, Adjudication, Medical Insurance Knowledge, Data Analysis, Multi-tasking
Be part of a team that unleashes the power of leading-edge technologies to help improve the health and well-being of those most vulnerable in our country and communities. Working at Gainwell carries its rewards. You’ll h…
Be part of a team that unleashes the power of leading-edge technologies to help improve the health and well-being of those most vulnerable in our country and communities. Working at Gainwell carries its rewards. You’ll h…
Skills: SQL Development, Data Analysis, MMIS, Medicaid Pharmacy Systems, X12 EDI Transactions
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Full-time
Posted 56d ago
Apply by Jun 25
~40 hrs/week
Responsibilities
Support the Business Process Services team by processing claims in accordance with policy guidelines. Evaluate claim errors and make adjudication decisions to meet production and quality requirements.
Requirements
Requires basic knowledge of medical or insurance concepts and fundamental computer skills. Candidates must be able to work independently and multi-task to meet individual production goals.
Full job description
Summary
As Provider Enrollment Analyst - Remote US, 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. Here are the details on this position.
Your role in our mission
Help create the power in Gainwell’s processes as we develop purpose-built technologies and solutions that yield better health and human services outcomes.
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
What we're looking for
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
What you should expect in this role
Opportunities to travel through your work (0-10%)
Related keywords
Claims ProcessingAdjudicationHealthcareInsuranceBusiness Process ServicesPolicy GuidelinesMedical BillingProduction GoalsQuality Requirements
The people who build careers at Gainwell Technologies share one thing: they want their work to matter. Here, it does.
We're the essential ingredient that makes Medicaid work.
For more than 50 years, we've combined our sweeping scale and technology to turn complex policies into thriving programs. We act as the crucial connection bringing the U.S. healthcare ecosystem together, and we partner with state agencies to modernize public health.
Our solutions translate complex member data into meaningful action. We streamline administration, connect vital systems, and drive efficiency. This gives providers more time to focus on delivering quality care to the people who need it most.
When we bring Medicaid touchpoints to life, members thrive. From fighting fraud and recovering improper payments to speeding up verifications, every solution we deploy expands what's possible for the future of healthcare.
Less burden, more mission. Gainwell.
The people who build careers at Gainwell Technologies share one thing: they want their work to matter. Here, it does.
We're the essential ingredient that makes Medicaid work.
For more than 50 years, we've combined our sweeping scale and technology to turn complex policies into thriving programs. We act as the crucial connection bringing the U.S. healthcare ecosystem together, and we partner with state agencies to modernize public health.
Our solutions translate complex member data into meaningful action. We streamline administration, connect vital systems, and drive efficiency. This gives providers more time to focus on delivering quality care to the people who need it most.
When we bring Medicaid touchpoints to life, members thrive. From fighting fraud and recovering improper payments to speeding up verifications, every solution we deploy expands what's possible for the future of healthcare.
Less burden, more mission. Gainwell.