Claims Examiner – Remote US

Gainwell Technologies; Idaho; Remote; USD 29,000 - 41,000; Full time

Benefits offered by this job

Health benefits from day one

401(k) matching

Educational assistance

Career development academies

Flexible vacation policy

Job summary

Gainwell Technologies seeks a Claims Examiner to join a remote US team. You will analyze and process healthcare claims, ensuring compliance with guidelines and documenting decisions for audit and reporting.

Collaborate with internal teams to resolve discrepancies, stay current on policies, and support continuous improvement while enjoying flexible hours and a comprehensive benefits package.

Qualifications

• Experience in claims processing or a related field.
• Strong organizational skills with attention to detail and accuracy.
• Excellent written and verbal communication skills.
• Ability to manage time and prioritize tasks effectively in a high-paced environment.
• Proficiency in Microsoft Office Suite and claims processing software.

Responsibilities

• Review and process healthcare claims in alignment with policies and regulations, ensuring accuracy and compliance.
• Document claim status, decisions, and follow-up actions, maintaining organized records for audit and reporting.
• Participate in quality control processes, ensuring claims are processed in a timely and accurate manner.
• Identify claim discrepancies and work with relevant teams to resolve issues efficiently.
• Maintain up-to-date knowledge of claims policies, industry regulations, and service requirements.

Skills

Organizational skills

Communication skills

Time management

Microsoft Office Suite

Claims processing software

Tools

Microsoft Office Suite

claims processing software

Job description

Claims Examiner – Remote US

Date: Sep 30, 2026
Location:

Any city, ID, US, 99999
Req ID: 38162
Work Mode: Default
It takes great medical minds to create powerful solutions that solve some of healthcare’s most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you’ve honed your career in a fast-moving medical environment. While Gainwell operates with a sense of urgency, you’ll have the opportunity to work more flexible hours. And working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values work-life balance, continuous learning, and career development.

Summary

As a Claims Examiner at Gainwell, you will be part of a team dedicated to supporting the accurate and timely processing of claims. In this role, you will analyze claims data, review and process claims to ensure compliance with claims guidelines and service standards.

Your role in our mission

• Review and process healthcare claims in alignment with policies and regulations, ensuring accuracy and compliance.
• Document claim status, decisions, and follow-up actions, maintaining organized records for audit and reporting.
• Participate in quality control processes, ensuring claims are processed in a timely and accurate manner.
• Identify claim discrepancies and work with relevant teams to resolve issues efficiently.
• Maintain up-to-date knowledge of claims policies, industry regulations, and service requirements.

What we’re looking for

• Previous experience in claims processing or a related field.
• Strong organizational skills with attention to detail and accuracy.
• Excellent written and verbal communication skills to interact effectively with team members.
• Ability to manage time and prioritize tasks effectively in a high-paced environment.
• Proficiency in Microsoft Office Suite and claims processing software.

What you should expect in this role

• Work remotelyfrom secure location within the United States, such as a home office, working 5 days per week.
• Collaborate with internal teams to improve claims processing workflows and resolve claim discrepancies.
• Opportunity to contribute to quality improvement initiatives in claims processing.
• Maintain a professional approach while interacting with healthcare providers
• Reliable home internet required: minimum 24 Mbps download / 8 Mbps upload (higher speeds strongly recommended).
• Opportunities for growth and advancement through Gainwell University and professional development programs.
• Health, dental, and vision benefits begin on day one, with 401(k) matching and additional benefits available.

LI-REMOTE

LI-JT1

The pay range for this position is $28,500.00 – $40,700.00 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.