Claims Specialist
Gainwell Technologies
full-time
Posted on:
Location Type: Hybrid
Location: Anchorage • Alaska • United States
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Salary
💰 $37,500 - $53,500 per year
About the role
- Processes moderately complex claims for Alaska Medicaid client.
- Makes decisions on payment of medical claims using existing policy and rules.
- Reviews and researches suspended medical claims and adjudicates them per DHS policy.
- Refers claims to Utilization Review and Provider Services units.
- Maintains necessary documentation.
- Participates in meetings as necessary.
- Participates in process improvement sessions.
- Trains as a back-up for other areas, such as document control, courier, and customer service desk.
Requirements
- Ability to work both independently and as part of a team.
- Strong communication skills with ability to communicate clearly and effectively in writing and verbally.
- Ability to access and retrieve information using a PC.
- Intermediate understanding of Microsoft Office products.
- Organizational skills to balance and prioritize work.
- Analytical and problem-solving skills.
Benefits
- generous, flexible vacation policy
- educational assistance
- comprehensive health benefits
- 401(k) employer match
- leadership and technical development academies
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Soft skills
communication skillsorganizational skillsanalytical skillsproblem-solving skillsability to work independentlyability to work as part of a team