Medical Claim Billing and Recovery - Medicaid TPL - Williston, VT (Hybrid)

Gainwell Technologies

  • Williston, VT
  • $35,000-50,000 per year
  • Permanent
  • Full-time
  • 28 days ago
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.SummaryCome join our Gainwell Financial Services team in Vermont! The team performs a wide variety of financial and third-party liability functions for Vermont-run health insurance programs. You'll start out by learning all about how we enable Vermont to save money through coordination of benefits activities with other insurers, and longer term will be cross trained in financial reporting and other financial services duties. The work is varied and challenging and requires someone who wants to use their talents to help us recover funds and to perform billing, reconciliation and reporting of those activities. This position offers full benefits including flexible vacation in order to ensure a work-life balance that supports a highly motivated team.Your role in our missionEssential Job Functions
  • Receiving Payments - from deposit, to posting the payment at the appropriate claim level detail
  • Review and research health insurance coverage
  • Retroactive billing of health insurance companies for newly accounted policies utilizing cost avoidance criteria
  • Identify potential TPL coverage
  • Research, enter and write-off TPL cash
  • Casualty / Trauma Review
  • Process the Explanation of Benefits and Payments from Other Insurance Carriers
  • Report TPL Activity
  • Process Claims Adjustment Requests - updating indicating claim detail as noted, and reprocessing the claim
  • Maintain Procedure documentation
  • Premium Payments to Other Carriers and Reconciliation of any payment discrepancies
  • Backup and Cross-training within the department
  • Other duties as assigned
What we're looking for
  • Associates Degree or better, or equivalent experience
  • 1-2 years' experience in medical claims billing preferred
  • Superior communications skills both written and verbal
  • Computer proficiency in Windows-based applications
  • Familiarity with either healthcare or insurance industries preferred
  • Problem Solving Skills
  • Attention to Detail
What you should expect in this role
  • HYBRID - On-site and WFH each week.
Hybrid about 50/50 - 2-3 days in office, 2-3 days WFH each week.#LI-HYBRID #JW1The pay range for this position is $35,000.00 - $50,000.00 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 , 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 and visit our 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.

Gainwell Technologies