Remote Quality & Compliance Verification Specialist

Gainwell Technologies LLC; Oregon; Hybrid; USD 50,000 - 72,000; Full time

Benefits offered by this job

Generous, flexible vacation policy

401(k) employer match

Comprehensive health benefits

Educational assistance

Leadership and technical development"

Job summary

Gainwell Technologies LLC is seeking a Quality Verification Specialist to review verification records for member and provider access requests and provider EFT changes, assessing identity, authority, and controls. This fully remote role offers a salary range of $50,400 to $72,000 per year, plus benefits such as a flexible vacation policy, 401(k) match, health coverage, and educational assistance.

You will collaborate with compliance, quality, privacy, and operations teams to ensure timely,

Qualifications

• 2+ years in member/provider services, healthcare operations, verification, quality assurance, compliance operations, or a related field.
• Ability to apply procedures and make evidence-based approval/denial decisions within delegated authority.
• Working knowledge of confidential-information protection, fraud indicators, and escalation practices.
• Clear written and verbal communication and collaboration across teams.

Responsibilities

• Review verification records and supporting evidence for member/provider access requests and provider EFT changes.
• Assess identity, representative authority, and required controls under approved procedures.
• Evaluate submission documentation for completeness, consistency, and compliance.
• Return incomplete or unsupported requests to submitting teams for correction.
• Record clear decision rationale and next steps, ensuring approvals where required.
• Identify discrepancies and privacy or security concerns and escalate.

Skills

Attention to detail

Communication

Critical thinking

Compliance awareness

Education

High school diploma or equivalent

Tools

Microsoft Office

SharePoint

Case management systems

Job description

Gainwell Technologies LLC is seeking a Quality Verification Specialist to review verification records for member and provider access requests and provider EFT changes, assessing identity, authority, and controls. This fully remote role offers a salary range of $50,400 to $72,000 per year, plus benefits such as a flexible vacation policy, 401(k) match, health coverage, and educational assistance.

You will collaborate with compliance, quality, privacy, and operations teams to ensure timely,