Healthcare Insurance Verification Specialist
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Job Description
Healthcare Insurance Verification Specialist at Gainwell assisting with insurance verification and data processing. Handling calls from Medicaid providers while ensuring compliance and excellent customer service.
Responsibilities:
- Handle inbound calls from Medicaid providers and members regarding insurance coverage and COB-related inquiries
- Verify and validate third-party insurance coverage using MMIS systems, carrier portals, and internal tools
- Accurately document and update case information across systems such as Perceptive Content and Excel
- Process back-office tasks including emails, faxes, and SharePoint requests tied to TPR contracts
- Interpret insurance coverage details and apply policy guidelines to ensure accurate information is communicated
- Support assigned contract operations (e.g., Idaho client) through dedicated back-office workflows
- Maintain compliance with HIPAA and data privacy standards while handling sensitive information
Requirements:
- High school Diploma/GED required.
- 1+ year of experience in medical insurance verification, healthcare operations, or related field
- 1+ year of call center or phone-based customer service experience
- Strong attention to detail and analytical skills for interpreting insurance coverage and data
- Proficiency in Microsoft Excel and ability to navigate multiple systems simultaneously
- Working knowledge of HIPAA privacy and security guidelines
Benefits:
- generous, flexible vacation policy
- 401(k) employer match
- comprehensive health benefits
- educational assistance
- variety of leadership and technical development academies
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