Job Details

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 Help Desk Representative - Healthcare - Remote Wisconsin job contains positions associated with providing consultancy utilizing knowledge and expertise on insurance and healthcare. Develops and implements general insurance and health policies in accordance with state and federal laws. Provides expertise to investigate and adjudicate claim characteristics that do not match policy provisions. Response to provider appeals and meets with trading partners and providers to resolve problems/issues. Provides directions for utilization review. Approves any remedial or recoupment actions associated with escalated claims. Advises provider review councils, states officials and works with organized healthcare groups and associations on various issues related to insurance and healthcare programs.

Your role in our mission

This is an important position in Gainwell's commitment to helping clients deliver better health and human services outcomes.

• Completes complex tasks, assignments and defined processes with some level of independence.
• Multiple assignments worked and completed simultaneously as directed by leadership.
• Identifies, prioritizes and resolves most question and issues independently. Answers questions of peers. Escalates more complex questions or issue appropriately.
• Complies with contract requirement, business unit rules and related industry and legal regulations.

What we're looking for

• 2-4 years of related work experience, including office administration.
• Strong organizational, time management, and self-motivation skills.
• Ability to follow written policies, procedures, and guidelines, and provide feedback to leadership.
• Intermediate knowledge of operating systems with the ability to interpret operation manuals, procedures, and healthcare/government guidelines.
• Excellent communication and customer service skills, including professional written, verbal, and telephone etiquette.

What you should expect in this role

• Video cameras must be used during all interviews, as well as during the initial week of orientation.
• Full-time (40 hours a week) Remote (work from home)
• 8-hour shift between the hours of 7:00 a.m. - 6:00 p.m. CT, Monday through Friday.
• Most benefits start on first day of employment
• In order to effectively work as a teleworker with Gainwell, employees Broadband Internet connections, should have a minimum speed of 24MBS download and 8 MBS upload. Greater speeds will of course provide better performance.
  This posting is intended for pipelining. We will accept applications on an ongoing basis.
  
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The pay range for this position is $29,100 - $41,600 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related 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. All 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 believe nothing is impossible when you bring together people who care deeply about making healthcare work better 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 our company website and visit our Careers site for all available job role openings.

Gainwell Technologies is an Equal Opportunity Employer, where all qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical condition), age, sexual orientation, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics.