Role OverviewJoin Gainwell as an Appeals Examiner to propel the company's operations and enhance the way they work and grow. This role involves reviewing, researching, and resolving healthcare provider appeals related to medical claims and payment determinations.
What You Will Do
Review and research provider appeals, analyze medical claims, and ensure all aspects of an appeal have been appropriately addressed. Maintain established productivity, accuracy, and quality standards while managing assigned appeals through resolution.
Why It Might Be a Fit
The ideal candidate brings strong medical claims or appeals experience, exceptional attention to detail, and the ability to consistently meet quality and productivity standards. This role offers the opportunity to support California's Medi-Cal program and grow your career in a company that values work flexibility, learning, and career development.
Requirements
- Two or more years of medical claims and/or appeals experience
- Experience researching and resolving healthcare claim payment issues
- Experience working with health insurance and medical terminology
- Strong research, analytical, and problem-solving skills with exceptional attention to detail and accuracy
- Proficiency with Microsoft Outlook, Word, Excel, Teams, and related business systems
Benefits
- Generous, flexible vacation policy
- 401(k) employer match
- Comprehensive health benefits
- Educational assistance
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