Medical Claims Resolution Analyst
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Job Description
Claims Resolution Analyst at Gainwell Technologies resolving medical claims in healthcare operations. Collaborating with internal teams and ensuring compliance with processing guidelines.
Responsibilities:
- Review, research, and resolve medical claims in accordance with established processing guidelines and procedures.
- Analyze claims issues and coordinate with internal departments to ensure timely and accurate resolution.
- Prepare and process claim-related documentation, including Return to Provider (RTP) forms when required information is missing or invalid.
- Manage multiple priorities while maintaining productivity, accuracy, and service-level expectations.
- Communicate claim status, workload updates, and potential issues to leadership and business partners as appropriate.
Requirements:
- Experience in healthcare insurance, medical claims processing, claims resolution, or a related healthcare operations environment.
- Strong attention to detail, analytical thinking, and problem-solving skills.
- Ability to multitask, prioritize work, and meet deadlines in a fast-paced environment.
- Proficiency with Microsoft Office applications and the ability to navigate multiple systems to research and process claims.
- Strong written and verbal communication skills, along with the ability to interpret policies, procedures, and operational guidelines.
Benefits:
- Health benefits
- 401(k) employer match
- Generous flexible vacation policy
- Educational assistance
- Leadership and technical development academies
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