Claims Examiner, Sr. Assistant Remote U.S.
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Gainwell Technologies LLC
OH
Summary
The Claims Examiner Assistant is responsible for entering insurance claims, verifying policyholder information, and investigating claims to determine resolution. They also handle incoming customer calls and coordinate with appropriate sources to obtain necessary information for claim processing.
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 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
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
“The deadline to submit applications for this posting is 9/30/2026.”
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.
The people who build careers at Gainwell Technologies share one thing: they want their work to matter. Here, it does.
We're the essential ingredient that makes Medicaid work.
For more than 50 years, we've combined our sweeping scale and technology to turn complex policies into thriving programs. We act as the crucial connection bringing the U.S. healthcare ecosystem together, and we partner with state agencies to modernize public health.
Our solutions translate complex member data into meaningful action. We streamline administration, connect vital systems, and drive efficiency. This gives providers more time to focus on delivering quality care to the people who need it most.
When we bring Medicaid touchpoints to life, members thrive. From fighting fraud and recovering improper payments to speeding up verifications, every solution we deploy expands what's possible for the future of healthcare.
Less burden, more mission. Gainwell.
Company size
10,001+ employees
Industry
IT Services and IT Consulting
Org type
Privately Held
Headquarters
United States
The people who build careers at Gainwell Technologies share one thing: they want their work to matter. Here, it does.
We're the essential ingredient that makes Medicaid work.
For more than 50 years, we've combined our sweeping scale and technology to turn complex policies into thriving programs. We act as the crucial connection bringing the U.S. healthcare ecosystem together, and we partner with state agencies to modernize public health.
Our solutions translate complex member data into meaningful action. We streamline administration, connect vital systems, and drive efficiency. This gives providers more time to focus on delivering quality care to the people who need it most.
When we bring Medicaid touchpoints to life, members thrive. From fighting fraud and recovering improper payments to speeding up verifications, every solution we deploy expands what's possible for the future of healthcare.
Less burden, more mission. Gainwell.
Company size
10,001+ employees
Industry
IT Services and IT Consulting
Org type
Privately Held
Headquarters
United States