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.

As a Claims Examiner at Gainwell, you will be part of a team dedicated to supporting the accurate and timely processing of claims. In this role, you will analyze claims data, review and process claims, and work directly with healthcare providers to ensure compliance with claims guidelines and service standards. This position requires onsite work 5 days per week at our Madison, WI office located at 313 Blettner Blvd, Madison, WI 53784.

Your role in our mission

• Review and process healthcare claims in alignment with policies and regulations, ensuring accuracy and compliance.
• Communicate with providers and healthcare professionals to clarify claims issues and obtain additional information as needed.
• Document claim status, decisions, and follow-up actions, maintaining organized records for audit and reporting.
• Participate in quality control processes, ensuring claims are processed in a timely and accurate manner.
• Identify claim discrepancies and work with relevant teams to resolve issues efficiently.
• Maintain up-to-date knowledge of claims policies, industry regulations, and service requirements.

What we're looking for

• Previous experience in claims processing or a related field.
• Strong organizational skills with attention to detail and accuracy.
• Excellent written and verbal communication skills to interact effectively with team members and providers.
• Ability to manage time and prioritize tasks effectively in a high-paced environment.
• Proficiency in Microsoft Office Suite and claims processing software.

What you should expect in this role

• Onsite position at our Madison, WI office, located at 313 Blettner Blvd, Madison, WI 53784, working 5 days per week.
• Collaborate with internal teams to improve claims processing workflows and resolve claim discrepancies.
• Opportunity to contribute to quality improvement initiatives in claims processing.
• Maintain a professional approach while interacting with healthcare providers and team members.
• Regularly report claim processing metrics and issues to leadership.
• Stay informed of industry updates and best practices for claims examination.

This posting is intended for pipelining. We will accept applications on an ongoing basis.

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The pay range for this position is $30,500 - $43,500 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 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), age, sexual orientation, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. Gainwell Technologies defines “wages” and “wage rates” to include “all forms of pay, including, but not limited to, salary, overtime pay, bonuses, stock, stock options, profit sharing and bonus plans, life insurance, vacation and holiday pay, cleaning or gasoline allowances, hotel accommodations, reimbursement for travel expenses, and benefits.