Job Description
About the position
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.
SummaryThe Professional Claims Analyst is responsible for analyzing insurance and matured endowment claims to ensure compliance with organizational standards, client requirements, and applicable regulatory guidelines. In this role, you will evaluate claims trends, assess financial reporting practices, and identify opportunities to improve claims systems and operational processes. This position requires strong analytical expertise, sound judgment, and a thorough understanding of claims procedures and industry standards.Your role in our mission
- Responsibilities
- Analyze insurance and matured endowment claims to ensure compliance with internal policies, client requirements, and government regulations.
- Monitor and evaluate claims trends to promote equitable and consistent claims processing practices.
- Conduct detailed investigations of claims systems and workflows to identify process improvement opportunities and recommend solutions.
- Review claims financial reporting and reconciliation practices, identifying discrepancies and recommending corrective actions.
- Inform leadership of potential liabilities, risk exposures, or operational enhancements related to current claims practices.
- Requirements
- Bachelor’s degree in insurance, business administration, or a related field, or an equivalent combination of education and experience.
- Minimum of three (3) years of claims experience, preferably within life and disability insurance environments.
- Experience working with industry-standard claims processing systems and investigative tools.
- Knowledge of claims processing procedures, documentation standards, administrative guidelines, and relevant legislative requirements.
- Strong analytical, problem-solving, and communication skills with the ability to evaluate complex claims scenarios.
- Reliable high-speed internet connection required for remote connectivity when applicable, with minimum download speed of 25 Mbps and upload speed of 10 Mbps.
- Benefits
- Access to Gainwell’s comprehensive benefits package in accordance with eligibility guidelines, including medical, dental, vision, 401(k), and other employee programs
- flexible vacation policy
- 401(k) employer match
- comprehensive health benefits
- educational assistance
- leadership and technical development academies
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