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Professional Claims Analyst

Claims SpecialistClaims SpecialistFull TimeRemoteSeniorTeam 10,001+H1B SponsorCompany SiteLinkedIn

Location

Texas

Posted

98 days ago

Salary

$47K - $67.2K / year

Seniority

Senior

Bachelor Degree3 yrs expEnglish

Job Description

Professional Claims Analyst

Gainwell Technologies

• Assist the Claims Manager with day-to-day Claims Team operations • Provide training and guidance to team members • Resolve claims issues by researching claim situations • Generate required client reporting and support audits • Assist with special projects and related team goals • Research and analyze paid and denied claims, POS system issues, and pricing discrepancies

Job Requirements

  • Bachelor’s degree in insurance, business administration, or related field
  • Minimum three years of claims experience
  • Experience with industry-standard claims processing systems and investigative tools
  • Knowledge of claims processing procedures and documentation standards
  • Ability to work under tight deadlines, manage multiple responsibilities, and work independently
  • Strong analytical, organizational, and problem-solving skills
  • Required understanding of pharmacy claims payment configuration processes and systems
  • Required pharmacy claims processing knowledge
  • Medicaid experience preferred
  • Strong written and verbal communication skills
  • General computer proficiency including Microsoft Office and Excel
  • Nationally Certified Pharmacy Technician certification

Benefits

  • Access to Gainwell’s comprehensive benefits package in accordance with eligibility guidelines
  • medical
  • dental
  • vision
  • 401(k)
  • other employee programs
  • flexible vacation policy
  • educational assistance
  • various leadership and technical development academies

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Brown Medicine logo

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