Gainwell Technologies LLC

Gainwell Technologies is seeking a Senior Verification Specialist to independently review and retest verification activities, assess member and provider interactions, and ensure compliance with confidentiality and control standards. The role emphasizes independence, reporting, and escalation of risks. Remote-focused opportunity across most US locations, with a pay range of $63,000 to $90,000 per year. The position includes a generous vacation policy, 401(k) match, health benefits, and #J-18808-Ljbffr

It takes great medical minds to create powerful solutions that solve some of healthcare’s most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you’ve honed your career in a fast-moving medical environment. While Gainwell operates with a sense of urgency, you’ll have the opportunity to work more flexible hours. And working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values work-life balance, continuous learning, and career development. Summary We are seeking a talented individual for a Lead Associate, Itemized Bill Review Quality Auditor to perform reviews of medical records, healthcare claims, itemized medical bill, and UB-04 forms to ensure accuracy, compliance, and proper billing practices. This role is responsible for conducting quality assurance audits and oversight of itemized bill review activities to ensure accuracy, consistency, regulatory compliance,...

Summary It takes great medical minds to create powerful solutions that solve some of healthcare’s most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you’ve honed your career in a fast-moving medical environment. While Gainwell operates with a sense of urgency, you’ll have the opportunity to work more flexible hours. And working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values work-life balance, continuous learning, and career development. Your role in our mission Performs audits of medical record documentation to determine the accuracy of principal and secondary diagnosis (including MCC & CC) and procedure codes. Adheres to official coding guidelines, coding clinics and regulatory guidelines and mandates. Draws on advanced ICD-10 coding expertise to substantiate conclusions. Utilizes HMS proprietary auditing systems with a high level of proficiency to...

Gainwell Technologies LLC is seeking a Coding Auditor to review medical record documentation for accuracy of principal and secondary diagnosis and procedures. You will apply advanced ICD-10 coding expertise and use HMS systems to document audit determinations and rationale. You will maintain up-to-date coding guideline knowledge and complete CEUs, while meeting productivity and quality standards. This remote role offers flexible hours and opportunities for professional growth. #J-18808-Ljbffr