Medical Claims Resolution Analyst - Remote US
$35,000–$50,000 year
Remote · United States
Job Summary
As a Claims Resolution Analyst at Gainwell, you will research, resolve, and process provider medical claims in accordance with established processing guidelines and procedures. You will analyze claims issues, coordinate with internal departments to ensure timely and accurate resolution, and prepare/process claim-related documentation including Return to Provider (RTP) forms when required information is missing or invalid. You will manage multiple priorities, maintain productivity and service-level expectations, and communicate claim status to leadership and business partners. The role requires experience in healthcare insurance, medical claims processing, or related healthcare operations, strong attention to detail, analytical thinking, multitasking ability, proficiency with Microsoft Office and multiple systems, and excellent written and verbal communication. Standard schedule is Monday through Friday, 8:00 AM to 5:00 PM. This posting is intended for pipelining with ongoing applications accepted. LI-REMOTE and LI-JT1 are noted.
Required Qualifications
- Experience in healthcare insurance, medical claims processing, claims resolution, or a related healthcare operations environment.
- Strong attention to detail, analytical thinking, and problem-solving skills.
- Ability to multitask, prioritize work, and meet deadlines in a fast-paced environment.
- Proficiency with Microsoft Office applications and the ability to navigate multiple systems to research and process claims.
- Strong written and verbal communication skills, along with the ability to interpret policies, procedures, and operational guidelines.
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