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.

Summary

As a Healthcare Claims Resolutions Specialist 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

• Demonstrated ability to work independently as well as collaboratively within a team environment.
• Excellent verbal and written communication skills, with the ability to convey information clearly and effectively.
• Proficiency in using a computer to access, retrieve, and manage information.
• Strong organizational skills with the ability to prioritize tasks and manage workloads efficiently.
• Analytical and problem-solving skills to address challenges and develop effective solutions.
• A strong work ethic paired with effective time management abilities.
• Proficiency in Microsoft Office Suite (e.g., Word, Excel, Outlook, and PowerPoint).
• Willingness to participate in meetings as needed to support team and organizational goals.
• Utilize various system data bases in order to appropriately adjudicate a suspended claim.
• Respond to emails quickly and precisely.

What we're looking for

• High School Diploma or GED.
• Minimum of 2 years of experience in customer service or claims processing, or a related field.
• Review and research suspended Medicaid claims and adjudicate them per DCH policy.
• Adhere to strict guidelines including HIPAA, company security, and company ethics.
• Intermediate understanding of Microsoft Office products.

What you should expect in this role

• This position is based in Tucker, GA.
• The work and training schedule is Monday through Friday, from 8:00 AM to 4:30 PM EST.
• Training: Approximately 2 weeks on-site.
• Assessment Requirement: Candidates will be required to complete a skills and competency assessment before advancing to the next stage of the selection process.
• Video Requirements: Video cameras must be on during all interviews and throughout the first week of orientation.
• Internet Requirements for Telework/Hybrid Roles: To work effectively in a telework or hybrid position with Gainwell, employees must have a broadband internet connection with a minimum speed of 24 Mbps download and 8 Mbps upload. Higher speeds are recommended for the best performance. To test your internet speed:
• Go to Google.
• Search for Internet Speed Test or click here.

Employee Benefits & Perks:

• Health benefits (medical, dental, and vision) begin on Day 1 of employment.
• 401(k) with company match and additional benefits become available within the first few months.
• Employees can take advantage of the flexible vacation policy after 90 days of employment. Any exceptions require manager approval before the employee's start date at Gainwell.
• Career growth and advancement opportunities are encouraged and supported.
• A company-provided computer is supplied for work use.

The deadline to submit applications for this posting is September 28, 2026.

#LI-HYBRID #LI-PP1 #LI-CM1

The pay range for this position is $30,500.00 - $43,500.00 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 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.