Assistant Claims Examiner

3 weeks ago


Ohio City, United States Gainwell Technologies Full time

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.

Summary

As an Assistant Claims Examiner 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. Here are the details on this position.

Your role in our mission

Perform important work in one of the most important areas of supporting state healthcare programs.

  • Support state Medicaid recovery efforts while following state law to ensure timely case management
  • Do the research on assets and probate, file court claims, work with stakeholders on case management, resolve outstanding issues and collect payment
  • Connect directly with attorneys and family members via phone or email regarding case status and when more information is needed to process a claim
  • Evaluate case information to validate asset information and probate case status
  • Advance cases to recovery by preparing the required correspondence, liens, claims and other related documents
  • Determine the payment amount and obtain the approval needed to disburse payments
  • Escalate contested cases to leadership as appropriate
What we're looking for
  • Probate, legal document and/or asset research/investigation work experience preferred
  • Knowledge of basic principles of case management with basic exposure to probate, LexisNexis, legal documents and Medicaid preferred
  • Basic investigative and problem-solving skills to evaluate cases and determine actions required
  • Past experience with HCPCS/ICD-10 coding & medical terminology preferred
  • Ability to pay close attention to detail and legal deadlines to ensure quality and timeliness of case management
What you should expect in this role
  • Fully remote opportunity in All USA Locations
  • LI-NA1

The pay range for this position is $12.75 - $18.25 per hour, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. Put your passion to work at Gainwell. You'll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits, and educational assistance. We also have a variety of leadership and technical development academies to help build your skills and capabilities.

We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Build your career with Gainwell, an industry leader. You'll be joining a company where collaboration, innovation, and inclusion fuel our growth. Learn more about Gainwell at our company website and visit our Careers site for all available job role openings.

Gainwell Technologies is committed to a diverse, equitable, and inclusive workplace. We are proud to be an Equal Opportunity Employer, where all qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical condition), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. We celebrate diversity and are dedicated to creating an inclusive environment for all employees.

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