Provider Relations Representative (Remote)

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 Associate Administrative in Provider Relations is responsible for reviewing supporting documentation that Providers submit to refute NYOMIG Disallowance projects . This position may require contacting the Provider via email or phone to request additional information to support their refute. The position also requires linking and routing some information which comes into our imaging systems.

Your role in our mission

• Deliver revenue for OMIG and save Medicaid dollars for programs administered by the State and Manage Care
• Review documentation to avoid recoupment of funds from Providers.
• Work with Providers to either or agree or disagree with disallowance claims based on letters/listing information.
• Educate Providers on how to submit documentation or request a refund.
• Encourage rapid response from Provider and follow-with those who don’t respond.
• Assist account managers in end of month cycle process to ensure timely reporting to our OMIG client

What we're looking for

• Customer Service background (Preferably in healthcare environment)
• Experience in billing and review of claims to make decisions on payment or denials.
• Familiar with working in Microsoft (especially Excel)
• Knowledge of HIPPA and PHI requirements
• Effective written and oral communication

What you should expect in this role

• Full-time position (40 hours per week)
• 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.
• To Test your internet download and upload speed:
• Go to Google 
• Search for Internet Speed Test or click here.  

 

 

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The pay range for this position is $16.00 to $24.00 per hour, 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.