Appeals Examiner - West Sacramento, CA

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Talent Acquisition Leader | Strategic Disruptor in Recruiting | Building High-Impact Teams with Intentional Engagement | Evolving Beyond "Post & Pray"

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

As an Appeals Examiner , you can contribute your skills as we harness the power of technology to help our clients improve the health and well-being of the members they serve — a community's most vulnerable.

Connect your passion with purpose, teaming with people who thrive on finding innovative solutions to healthcare's biggest challenges.

Your role in our mission

• Review provider appeals using approved guidelines and documents appeal determinations clearly and concisely.
• Analyze, research and review appeal documentation to ensure all aspects of the appeal 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

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Highly proficient with an exceptional level of accuracy.

What You Should Expect In This Role

Must be a resident of the Greater Sacramento area of California.

This posting is for pipelining. We will accept applications on an ongoing basis.

The pay range for this position is [[salaryMin]] - [[salaryMid]] per year, depending on geographic region, internal equity, knowledge, skills, and experience. Gainwell offers benefits including flexible vacation, 401(k) match, health benefits, and educational assistance.

Gainwell is an Equal Opportunity Employer. All qualified applicants will receive consideration without regard to race, religion, color, national origin, gender, age, sexual orientation, veteran status, disability, or other protected characteristics.

Additional Details

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