Medical Claims Auditor (Remote - Texas)
Gainwell TechnologiesTexas, United States
Posted January 30, 2026
30500 - 42500 USD
Full Time
About the Company
Gainwell is an industry leader that values work flexibility, learning, and career development.
Job Description
Medical Claims Auditor is responsible for reviewing and analyzing medical claims to ensure accuracy, compliance, and adherence to company and regulatory standards.
Requirements
- Minimum of three (3) years of direct medical claims collections experience
- Strong knowledge of insurance policy types (HMO, PPO, EPO, Medicare, Medicaid) and the medical claims lifecycle
- Advanced understanding of Explanation of Benefits (EOBs) and medical billing forms UB-04 and HCFA-1500
- Experience navigating payer portals and health information systems (e.g., Availity, Navinet)
- Demonstrated ability to perform high-volume outreach and communication, including 30+ daily contacts with providers and insurance carriers
Benefits
- Flexible vacation policy
- 401(k) employer match
- Comprehensive health benefits
- Educational assistance
