Healthcare Insurance Verification Specialist (Any city, TX, US, 99999)

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 Healthcare Insurance Verification Specialist (Remote) at Gainwell, you will support Coordination of Benefits (COB) and Third-Party Recovery (TPR) operations by assisting with insurance verification, data processing, and provider/member inquiries. This role plays a critical part in helping government and commercial healthcare payers reduce costs, improve quality, and maintain regulatory compliance. You will operate in a fast-paced, production- and quality-driven environment, balancing inbound call support with back-office processing activities while ensuring accuracy, compliance, and excellent customer service. Your role in our mission

• Handle inbound calls from Medicaid providers and members regarding insurance coverage and COB-related inquiries
• Verify and validate third-party insurance coverage using MMIS systems, carrier portals, and internal tools
• Accurately document and update case information across systems such as Perceptive Content and Excel
• Process back-office tasks including emails, faxes, and SharePoint requests tied to TPR contracts
• Interpret insurance coverage details and apply policy guidelines to ensure accurate information is communicated
• Support assigned contract operations (e.g., Idaho client) through dedicated back-office workflows
• Maintain compliance with HIPAA and data privacy standards while handling sensitive information

What we’re looking for

• High school Diploma/GED required.
• 1+ year of experience in medical insurance verification, healthcare operations, or related field
• 1+ year of call center or phone-based customer service experience
• Strong attention to detail and analytical skills for interpreting insurance coverage and data
• Proficiency in Microsoft Excel and ability to navigate multiple systems simultaneously
• Working knowledge of HIPAA privacy and security guidelines

What you should expect in this role

• Remote role (DFW area preferred) supporting multiple TPR contracts
• Schedule: Monday–Friday, 10:00 AM – 6:30 PM CST
• Video cameras must be used during all interviews, as well as during the initial week of orientation.
• As part of our interview process, all candidates must complete the Harver Assessment. This assessment helps us evaluate key competencies relevant to the role, including communication skills, multitasking abilities, and problem-solving capabilities.

The deadline to submit applications for this posting is April 16, 2026. The pay range for this position is $26,500.00 - $37,800.00 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 To this Job