Provider Service Analyst, Medicaid, Remote, USA

Overview

Remote
On Site
USD 51,700.00 - 73,800.00 per year
Full Time

Skills

Medicaid
Scheduling
Policies and Procedures
Finance
Account Analysis
Data Mining
Billing
Auditing
Analytical Skill
Conflict Resolution
Problem Solving
Microsoft Word
Microsoft Excel
Augmented Reality
Management
Attention To Detail
Adaptability
Regulatory Compliance
HIPAA
Expect
Leadership
Health Care
Collaboration
Innovation

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

We are seeking a talented individual for a Provider Services Analyst - Medicaid who provides on-site and remote account analysis for identifying and recovering client overpayments made to healthcare providers. Responsible for provider outreach and scheduling on-site reviews. Responsible for developing and managing Provider relationships, working independently to identify and secure Provider refunds. Explains audit policies and procedures to the provider; conducts exit conferences to review findings, and reschedules subsequent audits. Responsible for providing successful field and remote performance within assigned territory.

Your role in our mission
  • Conducts on-site and remote financial account analysis to identify overpayments, discrepancies, and billing errors.
  • Reviews provider Aged Trial Balance and Debit Adjustment reports to select claims for audit.
  • Communicates with provider personnel throughout the audit process and delivers summary reports.
  • Identifies refund trends and recommends data mining opportunities to optimize revenue.
  • Prepares and shares credit balance worksheets and audit findings with providers and internal teams.

What we're looking for
  • 3+ years of healthcare billing, audit, or AR experience preferred; strong analytical and problem-solving skills.
  • Proficient in Microsoft Word and Excel; quick to learn provider AR systems and payer standards.
  • Able to manage multiple priorities independently under tight deadlines.
  • Detail-oriented, adaptable to changing regulations, and committed to quality and compliance (e.g., HIPAA).
  • Willingness to travel up to 25% and work extended hours as needed.

What should you expect in this role
  • Remote in all USA Location
  • #LI-NA1
  • #LI-Remote

The pay range for this position is $51,700.00 - $73,800.00 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 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 committed to a diverse, equitable, and inclusive workplace. We are proud to be 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), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. We celebrate diversity and are dedicated to creating an inclusive environment for all employees.
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About Gainwell Technologies LLC