Professional Claims Analyst - Remote US

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

The 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

• 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.

What we're looking for

• 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.

What you should expect in this role

• Office-based work environment with collaboration across claims, compliance, and leadership teams.
• High level of responsibility in reviewing sensitive financial and personal data while maintaining strict confidentiality.
• Opportunities to contribute to continuous improvement initiatives that enhance claims accuracy, reporting, and operational efficiency.
• Reliable high-speed internet connection required for remote connectivity when applicable, with minimum download speed of 25 Mbps and upload speed of 10 Mbps.
• Access to Gainwell’s comprehensive benefits package in accordance with eligibility guidelines, including medical, dental, vision, 401(k), and other employee programs

The pay range for this position is $47,000.00 - $67,200.00 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 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), age, sexual orientation, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. Gainwell Technologies defines “wages” and “wage rates” to include “all forms of pay, including, but not limited to, salary, overtime pay, bonuses, stock, stock options, profit sharing and bonus plans, life insurance, vacation and holiday pay, cleaning or gasoline allowances, hotel accommodations, reimbursement for travel expenses, and benefits. Apply tot his job Apply To this Job