REFERENCE ANALYST- HYBRID

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

As REFERENCE ANALYST- HYBRID, you can contribute your skills as we harness the power of technology to help our clients improve the health and well-being of the members they serve - a community's most vulnerable. Connect your passion with purpose, teaming with people who thrive on finding innovative solutions to some of healthcare's biggest challenges. Here are the details of this position.

Your role in our mission

Liaison with DVHA for coding and pricing review

Update and administer changes to the Reference file Screens to ensure MMIS Processing system reflects Correct Coding and requested attributes.

Set up relationship and/or limitation audits as directed by DVHA.

• Work with the Systems team to implement and verify reference changes with a higher volume of updates.
• Maintain Resolution Pages as applicable.
• Review MMIS Data to identify areas out of compliance with Correct Coding and recommend necessary changes as identified to the DVHA.
• Maintain documentation to support all reference file updates applied to the system.

What we're looking for

• Oral and written communication skills
• Knowledge of VT Medicaid Policy
• Strong Attention to detail
• PC skills
• Microsoft Word
• Microsoft Excel
• Proficiency with claims billing
• CPC certification preferred but not required.

What you should expect in this role

• Hybrid
• Training is on-site.

#LI-HYBRID #LI-JW

The pay range for this position is $35,000.00 - $50,000.00 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 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.