Appeals Examiner - West Sacramento, CA (On-site)

Summary As Appeals Examiner – West Sacramento, CA (On‑site), you support our mission by leveraging technology to help our clients improve the health and well‑being of the members they serve. Your role in our mission Review provider appeals using approved guidelines and documents, documenting appeal determinations clearly and concisely. Analyze, research, and review appeal documentation to ensure all aspects have been addressed properly and accurately while maintaining production goals and quality standards. Resubmit and adjust claims on approved appeals with the proper claim data correction and documentation. Maintain performance within defined quality and quantitative objectives. Maintain confidentiality and comply with HIPAA. What We’re Looking For At least 2 years of experience in medical claims and appeals. Experience working with medical insurance and/or medical terminology. Highly proficient with an exceptional level of accuracy required. Ability to research and verify claim payment issues. Knowledge of Microsoft products (Outlook, Word, Excel, and Teams). What You Should Expect in This Role This is an on‑site/office environment at West Sacramento, CA. Hours are 6:00 a.m. – 2:30 p.m. The pay range for this position is $37,500.00 – $53,500.00 per year; the base pay offered may vary depending on geographic region, internal equity, job‑related knowledge, skills, and experience among other factors. 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. Gainwell is an industry leader that values collaboration, innovation, and inclusion. Learn more about Gainwell on our company website and visit our Careers site for all available job openings. Gainwell Technologies is an Equal Opportunity Employer; 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.” #J-18808-Ljbffr Gainwell Technologies