Provider Service Analyst - Medicaid

March 7

🌶️ New Mexico – Remote

Although this job is listed in New Mexico, this company may be open to hiring remote in other states.

💵 $35.2k - $50.3k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🧐 Analyst

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Gainwell Technologies

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Gainwell Technologies is the nation’s leading provider of digital and cloud-enabled solutions across the human services and public health ecosystem. With a mission-driven approach, Gainwell serves clients in all 50 U. S. states, focusing on improving health outcomes and delivering intuitive, human-centered experiences. Their comprehensive suite of solutions includes Medicaid Enterprise modernization, data analytics, provider services, and pharmacy solutions, all designed to advance the future of healthcare and enhance community well-being.

10,000+ employees

⚕️ Healthcare Insurance

💰 Grant on 2023-06

📋 Description

• Provides on-site and remote financial account analysis • Analyzes the following situations to identify instances of overpayments and clarifies discrepancies: Payment received by more than one payor, Retroactive payments, Double billing/payments, Inaccurate postings, Charges written off in excess of amounts actually billed, Debit contractual adjustments • Analyzes provider Aged Trial Balance and Debit Adjustment reports • Schedules, provides follow up and communication with provider personnel throughout duration of review • Identifies refund trends that can be applied across contract base to maximize revenue

🎯 Requirements

• 3+ years of healthcare billing experience, audit or collection and accounts receivable experience preferred but not required • Ability to function effectively under pressure and deadline oriented project demands • Ability to analyze information, use logic and processes to overcome obstacles and resolve problems • Ability to multi-task, establish priorities, and work independently to meet objectives • Ability to work proficiently with Microsoft Word and Excel • Ability to quickly gain a sound foundation of knowledge of the various major provider accounts receivable systems • Ability to work effectively in both team and independent environments • Ability to follow instructions and established work protocols • Ability to organize well • Ability to be versatile and easily adaptable to new regulations and rules from client to client • Ability to assimilate to diverse national payer standards, per client needs • Ability to remain knowledgeable of current payer specific reimbursement regulations • Ability to be detail oriented and quality focused • Ability to adhere to corporate policies and guidelines concerning audit protocol and adherence to HIPAA guidelines • Ability to maintain and enhance existing customer relationships • Healthcare reimbursement or claim knowledge • Understanding of coordination of benefit rules • Understanding of healthcare claim billing and collection terminology • May be required to work extended hours for special business needs • May be required to travel at least 25% of time based on business needs

🏖️ Benefits

• generous, flexible vacation policy • 401(k) employer match • comprehensive health benefits • educational assistance • leadership and technical development academies