Summary
As Provider Enrollment Analyst - Remote US, you can contribute your skills as we harness the power of technology to help our clients improve the health and well-being of the members they serve — a community’s most vulnerable. Connect your passion with purpose, teaming with people who thrive on finding innovative solutions to some of healthcare’s biggest challenges. Here are the details on this position.
Your role in our mission
Help create the power in Gainwell’s processes as we develop purpose-built technologies and solutions that yield better health and human services outcomes.
Share your expertise as you support the Business Process Services team in claims processing that adheres to policy guidelines
Meet production and quality requirements established by clients for timely claims processing
Use policy guidelines and criteria established by leadership to evaluate why a claim errored and make an adjudication decision
What we're looking for
Knowledge of the fundamental concepts and principles in the medical and/or insurance fields
Basic reading and analysis skills to evaluate claims and make adjudication decisions
Basic computer use skills
Ability to multi-task across multiple claims to work efficiently
Ability to work independently to meet individual production goals
What you should expect in this role
Gainwell Technologies is a healthcare technology company that develops and maintains Medicaid Management Information Systems (MMIS) and related healthcare solutions. The company specializes in building advanced healthcare platforms that support vulnerable populations, including pharmacy solutions with point-of-sale, prior authorization, online portals, and preferred drug list management. Gainwell leverages leading-edge technologies such as AI, GenAI, and cloud infrastructure to improve healthcare outcomes and operational efficiency. The company serves a diverse and growing client base of states and districts, managing large-scale implementations and ongoing operations across multiple environments.
