Immediate Hiring For Claims Processor

Claims Resolution Representative Hybrid Warrick, RI
Great companies need great teams to propel their operations. Perform routine but moderately complex tasks that are related to healthcare policy and claims processing including prior authorizations, third-party liability, and manual pricing. Apply knowledge of established procedures and policy to research and resolve customer questions or management requests utilizing policy manuals. Ensure that claims are processed according to state and federal regulations while meeting contractual obligations. Resolve most problems and escalates only the most complex issues to immediate supervisor. Examples of work performed may include preparing correspondence, report preparation, verifying data, researching, completing forms collections and data entry. Involved in the training of new employees and may take the lead in areas of expertise.

Resolve suspended medical claims utilizing Medical Assistance Policy.

Entry and/or approval of medical Prior Authorizations.

Entry and maintenance of third‑party insurance information to facilitate coordination of benefits and benefit recovery.

Identification of accident‑related claims.

Healthcare, insurance, or third‑party billing experience helpful.

Experience with Microsoft Outlook, Word, and proficiency with Excel.

Ability to interpret healthcare policy, laws, and regulations.

On‑site environment located in Warwick, RI. Hybrid possible after training.

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. 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.

You’ll be joining a company where collaboration, innovation, and inclusion fuel our growth.

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.”

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