2764 IT & Software Developer jobs in the US
Appeals examiner
$37,500 - 53,500
Gainwell Technologies LLC
Stillwater Road 820, West Sacramento
$37,500 - 53,500
Requirements
Must:
- Minimum of 2 years experience in medical claims and appeals required.
- Proven experience with medical insurance and/or medical terminology required.
- High proficiency with exceptional attention to detail required.
- Ability to investigate and resolve claim payment discrepancies.
- Familiarity with Microsoft products (Outlook, Word, Excel, and TEAMS) is essential.
Responsibilities
- Evaluate provider appeals in accordance with established guidelines and articulate appeal decisions clearly.
- Conduct thorough analysis and examination of appeal documents to ensure all facets of the appeal are correctly addressed while achieving production and quality requirements.
- Amend and resubmit claims on successful appeals with accurate correction and necessary documentation.
- Uphold performance standards within set quality and quantitative targets.
- Ensure confidentiality and adhere to the Health Insurance Portability and Accountability Act (HIPAA).
Description
At Gainwell, we are committed to solving business challenges and facilitating growth in the healthcare sector. As an Appeals Examiner, you will play a crucial role in utilizing technology to assist our clients in improving health outcomes for vulnerable populations. We offer an onsite working environment in West Sacramento, CA, with hours from 6:00 a.m. to 2:30 p.m. Our company values career development, work flexibility, and offers a competitive salary range between $37,500 and $53,500 per year, along with comprehensive health benefits, a 401(k) match, generous vacation policy, and educational assistance. Join us in our mission to innovate healthcare and make a significant difference in our community.
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The company with most openings is Lockheed Martin Corporation as they are hiring for 260 different Business Specialist jobs in the United States. They are probably quite committed to find good Business Specialists.
The company with most openings is Lockheed Martin Corporation as they are hiring for 260 different Business Specialist jobs in the United States. They are probably quite committed to find good Business Specialists.