Claims Resolution Analyst

Job title: Claims Resolution Analyst

About the Role Gainwell Technologies is responsible for Claims Operations and Management functions supporting Medical Assistance Services programs. As a Claims Resolution Analyst, you will play a key role in researching, resolving, and processing provider claims while ensuring accuracy, compliance, and exceptional customer support. This role helps power Gainwell's processes as we develop purpose-built technologies and solutions that yield better health and human services outcomes.

What You'll Do

• Review, research, and resolve medical claims in accordance with established processing guidelines and procedures.
• Analyze claims issues and coordinate with internal departments to ensure timely and accurate resolution.
• Prepare and process claim-related documentation, including Return to Provider forms when required information is missing or invalid.
• Manage multiple priorities while maintaining productivity, accuracy, and service-level expectations.
• Communicate claim status, workload updates, and potential issues to leadership and business partners as appropriate.

What We're Looking For

• Experience in healthcare insurance, medical claims processing, claims resolution, or a related healthcare operations environment.
• Strong attention to detail, analytical thinking, and problem-solving skills.
• Ability to multitask, prioritize work, and meet deadlines in a fast-paced environment.
• Proficiency with Microsoft Office applications and the ability to navigate multiple systems to research and process claims.
• Strong written and verbal communication skills, along with the ability to interpret policies, procedures, and operational guidelines.

Compensation & Benefits

• The pay range for this position is $35,000 - $50,000 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors.
• 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.