Medicaid Caseworker - Remote US
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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
HMS makes the healthcare system work better for everyone. We fight fraud, waste, and abuse so people have access to healthcare—now and in the future. Using innovative technology and powerful data analytics, we help government and commercial payers reduce costs, increase quality, and achieve regulatory compliance. We also help consumers take a more active role in their own health. Each year, we save our clients billions of dollars while helping people live healthier lives. At HMS, you will develop new skills and build your career in a dynamic industry while making a difference in the lives of others.
We are seeking a talented individual for a Senior Subrogation Case Worker role, who is responsible for processing all probate and estate functions involving several state Medicaid beneficiaries or deceased Medicaid beneficiaries. This includes intake, maintenance, claims review and selection, asset investigation, court filings and deadline management, settlement and other related functions to the case.
Your role in our mission
- Interact professionally (i.e. on incoming and outgoing calls) with attorneys, court staff, recipients and family members and client.
- Effectively maintain and manage a variety of cases with current and accurate notes from creation to recovery.
- Maintain a daily system of providing timely and accurate information required to move cases through the case management workflow.
- Daily telephone contact with counterparties, including attorneys and healthcare providers.
- Confirm and validate third party liability and, probate and beneficiary asset research.
- Prepare required correspondence, liens, claims and other related documents to progress the case to recovery.
- Negotiate and compromise claim/lien settlement amounts per contract guidelines.
- Process all claim/lien disputes and review claims with attorneys and other stakeholders.
- Conduct outgoing follow up on case status and payment.
- Perform basic and advanced levels of document review to identify current case status, legal research, and case management and ensure case progress through workflow
- Prioritize case events and critical case payment/recovery issues, while meeting, various internal and legal deadlines that are revenue impacting.
- Compile, analyze and make conclusions about case information and status from multiple sources.
What we're looking for
- High school diploma or GED.
- Experience working in a legal office, Medicaid office, or similar professional environment.
- Experience as a paralegal, legal assistant, county caseworker, county technician, or in a comparable role.
- Experience reviewing or interpreting real estate documents.
- Proficiency in Microsoft Outlook, Word, and Excel.
What you should expect in this role
- This is a remote position in USA.
- Work schedule is Monday – Friday, from 8-5 PM
- Video cameras must be used during all interviews, as well as during the initial week of orientation.
- To work effectively as a teleworker or hybrid positions with Gainwell, employees must have a broadband internet connection with a minimum speed of 24 Mbps download and 8 Mbps upload. Higher speeds are recommended for optimal performance.
- To test your internet speed, go to Google and search for “Internet Speed Test.”
The deadline to submit applications for this posting is July 29, 2026.
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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.
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