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Member Grievance and Appeals Customer Support Clerk - Fully On-Site / Roseville, California

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 a Member Grievance and Appeals Customer Support Clerk at Gainwell Technologies 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 on this position.

Your role in our mission

  • Retrieves new appeals information from the Appeals Case Management System (ACMS), research denial, saves all pertinent documents and the Customer Relationship Management System (CRM) using ACMS, MEDS, CD-MMIS, and EIMS

  • Mails Conditional Withdrawal letters, radiograph requests, EPSDT requests and Position Statements, reviewing all for HIPAA accuracy and uploads Position Statements, Conditional Withdrawals, and additional information to ACMS.

  • Monitors CRM’s Correspondence and Correspondence email queues. Closes completed cases and forwards cases from email queue that require follow-up by analyst.

  • Updates the Correspondence SHS and/or CRM system with hearing schedules, pre-hearing contacts, additional information received, Open Record letters and decisions.

  • Scanning and uploading incoming documents and creating tasks in ACMS for case completion

What we're looking for

  • Strong Communication (oral and written).

  • Strong typing and word-processing skills are a must.

  • Excellent organizational skills needed. Problem-solving, basic math, and computer skills needed.
    Ability to navigate through several work systems simultaneously desired. Microsoft Word, CD-MMIS, MEDS, and Excel experienced preferred.

What you should expect in this role

  • Must be a resident of the state of California.

  • Full-time, onsite position. The office is located in the Roseville/Sacramento area.


#LI-FULLYONSITE

#LI-CB1

 

 

The pay range for this position is $37,500.00 - $53,500.00 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.

Average salary estimate

$45500 / YEARLY (est.)
min
max
$37500K
$53500K

If an employer mentions a salary or salary range on their job, we display it as an "Employer Estimate". If a job has no salary data, Rise displays an estimate if available.

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Gain Momentum Join us in our mission to help those most vulnerable get the quality healthcare they need to live happy, healthier lives. Every day at Gainwell, we harness the power of technology to help our clients improve the health and well-being...

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Full-time, on-site
DATE POSTED
April 7, 2025

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