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
As an Claims Examiner – Englewood, CO at Gainwell, 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
- Support state Medicaid recovery efforts while following state law to ensure timely case management
- Enters insurance claims received electronically or in written form.
- Answers incoming customer calls regarding claim processing. Documents claim and associated history.
- Evaluates available information to validate straightforward basic claims. Verifies policyholder information, policy effective dates, premium status and verification of claim eligibility.
- Sends claim form to claimant for updating, correction or completion.
- Identifies need for additional information; contacts appropriate source to obtain needed information. Verifies beneficiary or claimant information if claim is warranted. Identifies payment amount and obtains required management approvals for payment. Processes payment.
- Advises claimant of status and resolution of claim. Escalates claimant concerns as appropriate.
What we’re looking for
- Probate, legal document and/or asset research/investigation work experience preferred
- Knowledge of basic principles of case management with basic exposure to probate, LexisNexis, legal documents, and Medicaid preferred
- One (1) or more years of claims experience required
- Experience working with insurance and/or medical terminology required
- Data entry experience required
What you should expect in this role
Must work full-time in our Englewood, Colorado office (not a work-from-home role)
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The pay range for this position is $26,500.00 – $37,800.00 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. Put your passion to work at Gainwell. You’ll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits, and educational assistance. We also have a variety of leadership and technical development academies to help build your skills and capabilities.
We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Build your career with Gainwell, an industry leader. You’ll be joining a company where collaboration, innovation, and inclusion fuel our growth. Learn more about Gainwell at our company website and visit our Careers site for all available job role openings.
Gainwell Technologies is committed to a diverse, equitable, and inclusive workplace. We are proud to be an Equal Opportunity Employer, where all qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical condition), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. We celebrate diversity and are dedicated to creating an inclusive environment for all employees.