Provider Enrollment Lead - Remote US
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Gainwell Technologies LLC
OH
Summary
Support the Business Process Services team in processing claims according to policy guidelines. Evaluate claim errors and make adjudication decisions to meet production and quality requirements.
Job Description
Summary
As Provider Enrollment Lead - Remote US, 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
Help create the power in Gainwell’s processes as we develop purpose-built technologies and solutions that yield better health and human services outcomes.
- Share your expertise as you support the Business Process Services team in claims processing that adheres to policy guidelines
- Meet production and quality requirements established by clients for timely claims processing
- Use policy guidelines and criteria established by leadership to evaluate why a claim errored and make an adjudication decision
What we're looking for
- Knowledge of the fundamental concepts and principles in the medical and/or insurance fields
- Basic reading and analysis skills to evaluate claims and make adjudication decisions
- Basic computer use skills
- Ability to multi-task across multiple claims to work efficiently
- Ability to work independently to meet individual production goals
What you should expect in this role
- Opportunities to travel through your work (0-10%)
For 50 years, our nation’s federal Medicaid program has worked to improve the health, safety and well-being of America’s most vulnerable populations: low-income families, women and children, seniors, and those with disabilities. With positive health and cost outcomes that pierce inequities and impact economies, the success of these programs is inextricably tied to the prosperity of communities, individual states and the nation as a whole. We think that demands respect and, more importantly, is deserving of a lifetime commitment from innovators who can help those who operate within and around health and human services evolve — in any market at any stage. At Gainwell Technologies, that’s our sole focus.
Built across more than five decades, Gainwell has intentionally seized opportunities to advance its digitally enabled services to meet agencies, health plans and MCOs where they are on their modernization journeys and propel them into the future of public health. Our commitment to innovation, deep experience and ability to leverage insights from customers across 50 states has allowed us to expand on next-generation, cloud-enabled technologies.
Today, Gainwell offers one of the most comprehensive suites of scalable services and solutions on the market — all proven to deliver cost savings, better patient outcomes and an improved provider experience. Equally important to our expanding technologies and results: We bring ideas that bring policies to life.
Company size
10,001+ employees
Industry
IT Services and IT Consulting
Org type
Privately Held
Headquarters
United States
For 50 years, our nation’s federal Medicaid program has worked to improve the health, safety and well-being of America’s most vulnerable populations: low-income families, women and children, seniors, and those with disabilities. With positive health and cost outcomes that pierce inequities and impact economies, the success of these programs is inextricably tied to the prosperity of communities, individual states and the nation as a whole. We think that demands respect and, more importantly, is deserving of a lifetime commitment from innovators who can help those who operate within and around health and human services evolve — in any market at any stage. At Gainwell Technologies, that’s our sole focus.
Built across more than five decades, Gainwell has intentionally seized opportunities to advance its digitally enabled services to meet agencies, health plans and MCOs where they are on their modernization journeys and propel them into the future of public health. Our commitment to innovation, deep experience and ability to leverage insights from customers across 50 states has allowed us to expand on next-generation, cloud-enabled technologies.
Today, Gainwell offers one of the most comprehensive suites of scalable services and solutions on the market — all proven to deliver cost savings, better patient outcomes and an improved provider experience. Equally important to our expanding technologies and results: We bring ideas that bring policies to life.
Company size
10,001+ employees
Industry
IT Services and IT Consulting
Org type
Privately Held
Headquarters
United States
