Remote Senior Claims Resolution Specialist

RemoteFetch; Maine; Remote; USD 31,000 - 44,000; Full time

Benefits offered by this job

401(k) employer match

Health benefits

Educational assistance

Flexible vacation policy

Leadership and technical development:

Job summary

Gainwell Technologies is seeking a Claims Resolution Analyst to research, resolve, and process provider claims with accuracy and compliance. The role emphasizes strong customer support and adherence to established guidelines across multiple systems.

The candidate should have healthcare claims experience, attention to detail, and solid communication skills to interpret policies and procedures in a fast-paced environment.

Qualifications

• 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.

Responsibilities

• 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.

Skills

Attention to detail

Analytical thinking

Problem solving

Communication

Multitasking

Prioritization

Tools

Microsoft Office

Job description

Gainwell Technologies is seeking a Claims Resolution Analyst to research, resolve, and process provider claims with accuracy and compliance. The role emphasizes strong customer support and adherence to established guidelines across multiple systems.

The candidate should have healthcare claims experience, attention to detail, and solid communication skills to interpret policies and procedures in a fast-paced environment.