Claims Examiner, Sr. Assistant Remote U.S.

Gainwell Technologies; Northern (KY); Hybrid; USD 52,000 - 70,000; Full time

Job summary

Gainwell Technologies is seeking a Claims Resolution Analyst to research, resolve, and process provider claims with a focus on accuracy and exceptional customer support.

You will work in a fast-paced healthcare operations environment, using multiple systems to investigate and resolve claim-related issues and partnering with internal teams to ensure timely outcomes.

Qualifications

• Experience in healthcare insurance and medical claims processing.
• Strong attention to detail and analytical thinking.
• Ability to multitask and meet deadlines in a fast-paced environment.

Responsibilities

• Review, research, and resolve medical and dental claims in accordance with processing guidelines and procedures.
• Analyze claims issues and collaborate with internal departments to ensure timely and accurate resolution.
• Manage multiple priorities while maintaining productivity, accuracy, and service level expectations.
• Communicate claim status, workload updates, and potential issues to leadership and partners as appropriate.
• Collaborate with internal teams to ensure accurate and timely claim outcomes.

Skills

Healthcare claims

Claims processing

Analytical thinking

Detail oriented

Communication skills

Tools

Microsoft Office

Claims systems

Job description

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Date: Sep 19, 2026

Location: Any city, ME, US, 99999

Work Mode: Virtual (Exception only)

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 Federal and State Medical Assistance Services programs. As aClaims 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

• Review, research, and resolve medical and dental claims in accordance with established processing guidelines and procedures.
• Analyze claims issues and collaborate with internal departments to ensure timely and accurate resolution.
• 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.