Provider Service Analyst, Medicaid, Remote, Local in New Mexico, USA

Freddie Mac; United States; Remote; USD 35,000 - 51,000; Full time

Job summary

An established industry player is looking for a dedicated Provider Services Analyst to join their team. This role involves conducting thorough financial account analysis to identify overpayments and discrepancies in healthcare billing. You will engage with healthcare providers, manage relationships, and ensure compliance with audit policies. With a focus on flexibility and career growth, this remote position offers a supportive environment where your contributions are valued. Join a company that champions diversity and inclusion while providing a comprehensive benefits package to enhance your professional journey.

Benefits

Flexible vacation

401(k) match

Health benefits

Educational support

Qualifications

• 3+ years of healthcare billing, audit, or collection experience preferred.
• Ability to work effectively under pressure and manage multiple initiatives.

Responsibilities

• Provides on-site and remote financial account analysis.
• Identifies refund trends for data mining projects and makes recommendations.

Skills

Healthcare billing experience

Audit experience

Collection experience

Microsoft Word proficiency

Microsoft Excel proficiency

Problem-solving skills

Ability to analyze information

Knowledge of healthcare reimbursement

Tools

Accounts receivable systems

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

We are seeking a talented individual for a Provider Services Analyst - Medicaid who provides on-site and remote account analysis for identifying and recovering client overpayments made to healthcare providers. Responsible for provider outreach and scheduling on-site reviews. Responsible for developing and managing provider relationships, working independently to identify and secure provider refunds. Explains audit policies and procedures to providers; conducts exit conferences to review findings, and reschedules subsequent audits. Responsible for providing successful field and remote performance within the assigned territory.

Your role in our mission

1. Provides on-site and remote financial account analysis; analyzes situations to identify overpayments and discrepancies, including:

• Payment received by more than one payor
• Retroactive payments
• Double billing/payments
• Inaccurate postings
• Charges written off in excess of billed amounts
• Debit contractual adjustments
• Reclassification of accounts
• Charges removed
• Provider A/R systems modeling net revenue at billing
• Incorrect coordination of benefits
• Payments outside payer guidelines

Analyzes provider aged trial balance and debit adjustment reports to determine claims for review.

Schedules, follows up, and communicates with provider personnel during reviews.

Identifies refund trends for data mining projects and makes recommendations.

Prepares credit balance worksheets or summary reports for providers and internal staff as needed.

What we're looking for

• 3+ years of healthcare billing, audit, or collection experience preferred but not required.
• Ability to work effectively under pressure, manage multiple initiatives, analyze information, and resolve problems.
• Proficiency with Microsoft Word and Excel.
• Quickly learn provider accounts receivable systems.
• Ability to work independently and in teams, follow instructions, organize well, and adapt to regulations.
• Knowledge of healthcare reimbursement, claim terminology, and coordination of benefits.
• Willingness to work extended hours and travel up to 25% as needed.

What to expect in this role

• Remote position based in New Mexico, USA.
• #LI-NA1
• #Remote-New Mexico

The salary range is $35,200 - $50,300 annually, with variations based on location, experience, and other factors. Gainwell offers a comprehensive benefits package, including flexible vacation, 401(k) match, health benefits, and educational support. Join us to grow your career in a company that values collaboration, innovation, and inclusion.

Gainwell Technologies is committed to diversity, equity, and inclusion. We are an Equal Opportunity Employer, welcoming applicants regardless of race, religion, gender, age, veteran status, disability, or other protected characteristics. We celebrate diversity and strive to create an inclusive environment for all employees.