医疗理赔解决分析师 - 远程蒙大拿州（任何城市，MT，美国，99999）
Medical Claims Resolution Analyst - Remote Montana (Any city, MT, US, 99999)
优秀的企业需要优秀的团队来推动运营。加入这个解决业务挑战并提升我们工作和成长方式的团队。在Gainwell工作有其回报。你将有机会在一个重视你的贡献，并注重工作灵活性、学习和职业发展的公司中，实现职业生涯的飞跃。
职位简介
Gainwell Technologies负责支持医疗援助服务项目的理赔运营和管理职能。作为理赔解决分析师，你将在研究、解决和处理供应商理赔的过程中发挥关键作用，同时确保准确性、合规性以及卓越的客户服务。
你在我们使命中的角色
作为团队一员，帮助打造Gainwell流程中的力量，我们将开发定制的技术和解决方案，以实现更好的健康和人类服务成果。
- 根据既定的处理指南和流程，审查、研究并解决医疗理赔。
- 分析理赔问题，并与内部部门协调，确保及时准确地解决。
- 准备和处理与理赔相关的文件，包括当所需信息缺失或无效时的供应商退回（RTP）表格。
- 在保持生产力、准确性和服务级别期望的同时，管理多个优先事项。
- 适时向领导和业务伙伴传达理赔状态、工作进展和潜在问题。
我们寻找的人选
- 具有医疗保健保险、医疗理赔处理、理赔解决或相关医疗运营环境的经验。
- 具备细致的注意力、分析思维和解决问题的能力。
- 能够多任务处理、合理安排工作优先级，并在快节奏环境中按时完成任务。
- 熟练使用Microsoft Office应用程序，并能够操作多个系统以研究和处理理赔。
- 具备良好的书面和口头沟通能力，能够理解政策、程序和操作指南。
你在这个职位中可以期待
- 在一个专注于理赔研究和解决的快节奏医疗运营环境中工作。
- 使用多个系统和工具来调查和处理与理赔相关的问题。
- 与内部团队合作，确保理赔结果的准确性和及时性。
- 按照公司政策和程序处理敏感和机密信息。
- 标准工作时间为周一至周五
查看英文原文
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
Gainwell Technologies is responsible for Claims Operations and Management functions supporting Medical Assistance Services programs. As a Claims Resolution Analyst, you will play a key role in researching, resolving, and processing provider claims while ensuring accuracy, compliance, and exceptional customer support.
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.
- Review, research, and resolve medical claims in accordance with established processing guidelines and procedures.
- Analyze claims issues and coordinate with internal departments to ensure timely and accurate resolution.
- Prepare and process claim-related documentation, including Return to Provider (RTP) forms when required information is missing or invalid.
- Manage multiple priorities while maintaining productivity, accuracy, and service-level expectations.
- Communicate claim status, workload updates, and potential issues to leadership and business partners as appropriate.
What we're looking for
- 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.
What you should expect in this role
- Work in a fast-paced healthcare operations environment focused on claims research and resolution.
- Utilize multiple systems and tools to investigate and process claim-related issues.
- Collaborate with internal teams to ensure accurate and timely claim outcomes.
- Handle sensitive and confidential information in accordance with company policies and procedures.
- Standard work schedule of Monday through Friday, 8:00 AM to 5:00 PM MT
*This posting is intended for pipelining. We will accept applications on an ongoing basis.
The pay range for this position is $35,000 - $50,000 per year, 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 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), age, sexual orientation, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. Gainwell Technologies defines “wages” and “wage rates” to include “all forms of pay, including, but not limited to, salary, overtime pay, bonuses, stock, stock options, profit sharing and bonus plans, life insurance, vacation and holiday pay, cleaning or gasoline allowances, hotel accommodations, reimbursement for travel expenses, and benefits.
Originally posted on Himalayas