Claims Appeals Team Lead - Onsite - West Sacramento, CA

Select how often (in days) to receive an alert: Claims Appeals Team Lead - Onsite - West Sacramento, CA Date: Sep 19, 2026 Location: West Sacramento, CA, US, 95605-1630 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 Gainwell Technologies is seeking an experienced Claims Appeals Team Lead to support appeals operations for California’s Medi-Cal program at our West Sacramento office. In this role, you will coordinate and support daily provider appeals operations to help ensure appeals are processed accurately, timely, and in accordance with established policies, regulatory requirements, and service-level expectations. Working under the direction of the Claims Appeals Supervisor, you will serve as a primary resource for Appeals Examiners, help coordinate daily workflow, provide training and guidance, monitor quality and performance, and assist with complex appeals and operational issues. Your role in our mission Coordinate daily provider appeals activities and help prioritize workloads to meet established turnaround times and service-level requirements. Provide day-to-day guidance, training, and operational support to Appeals Examiners and other team members. Review provider appeals for accuracy, completeness, and compliance with established policies, procedures, and departmental standards. Assist with quality assurance activities, identify processing issues or trends, and support corrective actions when needed. Track productivity, quality, turnaround times, inventory, and other performance metrics and provide status updates to leadership. Support process improvements designed to increase efficiency, improve accuracy, reduce operational issues, and enhance the provider experience. What we're looking for Three or more years of experience in healthcare claims, appeals and grievances, provider appeals, Medicaid/Medi-Cal, or a related healthcare function. Experience reviewing, researching, processing, or resolving healthcare claims or provider appeals. Previous experience as a team lead, senior claims examiner, senior appeals examiner, or in a role providing day-to-day guidance and support to other employees is preferred. Strong analytical and critical-thinking skills with excellent attention to detail and a commitment to quality and accuracy. Ability to train, coach, and support team members while helping coordinate workflow in a high-volume environment. Strong written and verbal communication skills with the ability to organize priorities and meet established deadlines. What you should expect in this role This is a 100% onsite position at our West Sacramento, CA office. Remote or hybrid work is not available for this role. Standard work schedule is Monday through Friday, 6:00 AM to 2:30 PM . You will work in a fast-paced, metrics-driven healthcare appeals environment requiring strong prioritization, accuracy, and timely decision-making. This is a hands-on lead role that requires supporting Appeals Examiners while helping monitor daily workflow, quality, productivity, and turnaround times. This posting is being used to build a pipeline of qualified candidates for current and future opportunities.

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The pay range for this position is $46,800 - $66,900 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. #J-18808-Ljbffr Gainwell Technologies