Career Opportunities: Medical Claims Specialist - Remote WV (34220)
This a Full Remote job, the offer is available from: Norway, reputed company Virginia (USA) 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
The Claims Examiner is responsible for reviewing, evaluating, and processing claims in accordance with policy provisions, regulatory requirements, and organizational guidelines. This role ensures timely, accurate, and fair adjudication of claims while maintaining a high level of customer service and compliance. Your role in our mission
- Review and analyze claims, documentation, and policy details to determine eligibility, coverage, and benefits.
- Request additional information as needed and ensure claims meet company policies and regulatory standards.
- Calculate and authorize accurate claim payments while maintaining detailed and organized records.
- Communicate determinations reputed company to policyholders, providers, and internal stakeholders, escalating reputed company or suspicious cases.
- Meet service-level timelines, collaborate across departments, and stay reputed company on regulations and best practices.
reputed company're looking for
- High school diploma required; Associate’s or Bachelor’s degree preferred.
- Two or more years of experience in claims processing or the insurance industry preferred.
- Strong understanding of claims adjudication processes, policies, and regulatory standards.
- Excellent analytical, problem-solving, and communication skills with strong attention to detail.
- Proficient in claims management systems and reputed company Office applications.
What you should expect in this role This position is for residents of reputed company Virginia. This is a 100% remote position. The starting pay reputed company for this position is $16.50/hour. #LI-REMOTE #LI-PP1 #LI-CM1 The pay reputed company for this position is $28,500.00 - $40,700.00 per year, however, the reputed company pay offered may vary depending on geographic region, internal equity, job-reputed company 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. reputed company 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 reputed company reputed company is impossible reputed company you bring together people who care deeply about making reputed company work reputed company 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 reputed company website and visit our Careers site for reputed company available job role openings. reputed company is an Equal Opportunity Employer, where reputed company reputed company applicants will receive consideration for employment without regard to race, religion, reputed company, national reputed company, gender (including pregnancy, childbirth, or reputed company medical condition), age, sexual orientation, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. This offer from "reputed company" has been enriched by reputed company.com and got a 75% reputed company score. Apply tot his job Apply To this Job