Assistant Claims Examiner

Gainwell Technologies; Ohio; Remote; USD 10,000 - 60,000; Full time

Job summary

Join a forward-thinking company as an Assistant Claims Examiner, where you will play a vital role in supporting state healthcare programs. This fully remote position offers you the chance to leverage your investigative skills to ensure timely case management and assist in Medicaid recovery efforts. Collaborate with a dedicated team to tackle healthcare challenges, all while enjoying the flexibility and growth opportunities that come with working for an organization that values your contributions. If you are passionate about making a difference in the community and thrive in a dynamic environment, this role is perfect for you.

Benefits

Flexible Vacation Policy

Educational Assistance

Leadership Development Programs

Technical Development Programs

Qualifications

• Experience in probate and legal document research is preferred.
• Knowledge of case management principles and Medicaid is a plus.

Responsibilities

• Support Medicaid recovery efforts and manage case information.
• Communicate with attorneys and family members regarding claims.

Skills

Probate Research

Legal Document Review

Asset Investigation

Problem-Solving

Attention to Detail

HCPCS / ICD-10 Coding

Tools

LexisNexis

Job description

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 will 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 by teaming with people who thrive on finding innovative solutions to healthcare's biggest challenges. Here are the details of this position.

Your role in our mission

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

1. Support state Medicaid recovery efforts while following state law to ensure timely case management.
2. Research assets and probate, file court claims, collaborate with stakeholders on case management, resolve outstanding issues, and collect payments.
3. Communicate directly with attorneys and family members via phone or email regarding case status and additional information needed to process a claim.
4. Evaluate case information to validate asset details and probate case status.
5. Advance cases to recovery by preparing the necessary correspondence, liens, claims, and related documents.
6. Determine the payment amount and obtain approval for disbursement.
7. Escalate contested cases to leadership as appropriate.

What we're looking for

1. Experience in probate, legal document, and/or asset research/investigation work preferred.
2. Knowledge of basic principles of case management, with exposure to probate, LexisNexis, legal documents, and Medicaid preferred.
3. Basic investigative and problem-solving skills to evaluate cases and determine necessary actions.
4. Experience with HCPCS / ICD-10 coding & medical terminology preferred.
5. Attention to detail and ability to meet legal deadlines to ensure quality and timeliness.

What you should expect in this role

• Fully remote opportunity across all USA locations.
• LI-NA1

The pay range for this position is $12.75 - $18.25 per hour. The actual base pay may vary depending on geographic region, internal equity, skills, experience, and other factors. Put your passion to work at Gainwell. You will have the opportunity to grow your career in a company that values work flexibility, learning, and career development. All full-time salaried candidates are eligible for our generous, flexible vacation policy, educational assistance, and access to leadership and technical development programs to enhance your skills and capabilities.