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Gainwell Technologies
Gainwell Technologies
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Gainwell Technologies develops digital and cloud-enabled solutions for the human services and public health ecosystem. The company works with clients across all 50 U.S. states on healthcare initiatives including Medicaid Enterprise modernization, data analytics, provider services, and pharmacy solutions. Its work connects technology with public health delivery, healthcare administration, and efforts to improve health outcomes and community well-being.
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Medical Claims Research Analyst - California Hybrid

Research and resolve complex medical claims, provider inquiries, and healthcare operational issues for Gainwell Technologies. This California hybrid role also supports escalations, process improvements, and knowledge-sharing.

USUnited StatesCACalifornia
$70,000 – $75,000 / year
HybridFull-timeMiddleSeniorEnglish RequiredResearch Analyst

Description

  • Investigate and resolve medical claims, provider inquiries, program questions, and operational issues ranging from routine to complex.
  • Oversee claims research and related correspondence by reviewing inquiries, tracking cases, prioritizing work, and delivering accurate, timely resolutions.
  • Work with providers, clients, leaders, and cross-functional teams to resolve issues, manage escalations, and advance program initiatives.
  • Record complex resolutions, recognize recurring trends, and help ensure policies and procedures are applied consistently.
  • Find opportunities to improve processes and recommend practical solutions that strengthen efficiency, service delivery, and customer outcomes.
  • Contribute to knowledge-sharing and training efforts.
  • Apply relevant federal, state, client, and organizational requirements.

Requirements

  • At least three years of experience in healthcare operations, medical claims processing, claims research, provider support, customer service, business process outsourcing, or a related area.
  • Background investigating and resolving medical claims, provider inquiries, and related healthcare operations issues.
  • Strong analytical, research, problem-solving, organizational, and decision-making abilities.
  • Capacity to manage competing priorities effectively.
  • Excellent written, verbal, and interpersonal communication skills.
  • Experience working with providers, clients, and cross-functional business partners.
  • Working knowledge of provider operations, medical claims processing, customer support practices, and business systems for researching, tracking, and resolving inquiries.
  • Experience evaluating business processes, spotting improvement opportunities, and developing practical solutions.
  • California residency is required.
  • Reliable high-speed internet access is required.

Benefits

  • Flexible work options.
  • Learning and career development opportunities.
  • Generous, flexible vacation policy.
  • 401(k) employer matching.
  • Comprehensive health benefits.
  • Educational assistance.
  • Leadership and technical development academies.
  • Remote work arrangement.

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