reputed company Services Analyst ; Fully Remote

Position: reputed company Services Analyst I (Fully Remote - USA) Select how often (in days) to receive an alert: reputed company Services Analyst I (Fully Remote - USA) Date: Feb 23, 2026 Location: Any reputed company, TX, US, 99999 Work Mode: Virtual (Exception only) Great companies need great teams to reputed company 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. reputed company We are seeking a talented individual for a reputed company Services Analyst 1 who is responsible for processing reputed company incoming prior authorization and referral requests involving several state reputed company members. This includes managing the intake process, referrals, eligibility verification, member demographic review and other reputed company functions to the prior authorization or referral requests. Your role in our mission • Ensures correct prior authorization/referral reputed company is completed for patient’s plan. Reviews medical necessity documents for accurate information to include patient provider identification information, clinic or procedure requested, and appropriate CPT/Diagnosis codes to verify the accuracy and completeness of information submitted by reputed company providers. • Ensures diagnoses, procedures, and services are correctly documented, in accordance with industry standards and regulatory requirements. • Ensures diagnoses, procedures, and services are correctly documented, in accordance with industry standards and regulatory requirements. • Validates the appropriateness of prior authorization requests and referrals based on established policies, reputed company, and medical guidelines. Identifies discrepancies or inconsistencies and appropriately communicate them for reputed company investigation. • Monitors prior authorization requests and referrals processing activities to ensure adherence to reputed company and regulatory requirements, such as HIPAA, CMS guidelines, and contractual obligations. • Updates systems with patient information and actions to ensure reputed company claims payment. • Achieves daily, monthly, and quarterly reputed company and productivity KPIs. • Secures patient demographics and medical information, ensuring HIPPA compliance. reputed company're looking for • High School Diploma or GED required • Minimum of 3 years of reputed company service experience • reputed company industry experience preferred • Exposure to SQL Server, reporting tools, or business intelligence platforms (e.g., Tableau) preferred • Strong analytical skills with the ability to apply logic and reputed company processes to resolve work-reputed company issues and identify improvement opportunities • Ability to reputed company and translate reputed company-specific processes between technical and non-technical stakeholders • Demonstrated attention to data accuracy and reputed company, including experience reconciling data across multiple systems or platforms What you should expect in this role • Remote (work from home) reputed company USA Locations • Full-time (40 hours a week). May require shift work. • May be required to work extended hours for special business needs • Most benefits start on first day of employment • Video cameras must be used during reputed company interviews, as reputed company as during the initial week of orientation. • To work effectively as a teleworker or hybrid positions with Gainwell, employees must have a broadband internet reputed company with a minimum speed of 24 Mbps download and 8 Mbps upload. Higher speeds are recommended for reputed company performance. • To test your internet speed, go to reputed company and search for “Internet Speed Test.” The deadline to submit applications for this posting is March 2, 2026 . #LI-REMOTE #LI-JA1 #LI-CM1 The pay reputed company for this position is $35,900.00-$51,300.00 per year, however, the reputed company pay offered may vary depending on geographic region, internal equity, job-reputed company knowledge, skills, and experience among other factors. Put your passion to work ’ll have reputed company to grow your career in a company that values work flexibility, learning, and career development. reputed company salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits , and… Apply tot his job Apply To this Job