Claims Adjustments and Data Capture Clerk - Tallahassee, FL (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 Claims Adjustments and Data Capture Clerk - Tallahassee, FL (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 on this position.

This position supports both the Claims Adjustments and Data Capture units within Florida Medicaid Claims Operations. The role is responsible for accurately processing approved claim adjustment activities as well as capturing and processing claim and document information. Both functions require a strong attention to detail, the ability to follow established procedures, and a commitment to timely and accurate client deliverables.

Your role in our mission

- Process various Florida Medicaid Claims Adjustment requests , including: Expenditure requests, Accounts Receivable (AR) requests, Claim history requests, Claim denial requests, and other approved adjustment activities

- Support Data Capture operations through the accurate keying and processing of required documents using FormWorks .

- Review source documents and accurately capture required claim and document information into the appropriate processing system.

- Process required daily Data Capture reports accurately and within established deadlines.

- Assist with the processing of high-dollar force-pay claims and other priority workloads.

- Identify incomplete, inconsistent, or questionable information and follow established procedures for resolution or escalation.

- Cross-train and maintain working knowledge of both Claims Adjustments and Data Capture functions to assist with changing operational and client priorities.

- Work collaboratively with team members, leadership, and other Claims Operations areas to ensure assigned work and client deliverables are completed accurately and timely.

What we're looking for

- High school diploma or equivalent required

- Previous experience with Florida Medicaid, healthcare claims, Claims Processing, Provider Enrollment, Data Capture, or other healthcare operations is preferred.

- Familiarity with healthcare claim forms, claim processing, or medical billing is preferred.

- Excellent attendance, verbal, and written communication skills.

- Strong attention to detail with a demonstrated ability to complete detailed processing work accurately.

- Basic computer proficiency with the ability to learn and navigate multiple processing applications.

What you should expect in this role

This is a hybrid role located in Tallahassee, FL

- Business hours between 8 am to 5 pm (Mon – Fri) .

- Initial 90-120 days may need to report to work onsite with possibility of hybrid after (based on overall performance).

- Must be available to work from home and in office/on site as per business needs.

- Must be able to meet established productivity, quality, accuracy, attendance, and processing deadlines.

- Position may require cross-training and assignment to either Claims Adjustments or Data Capture based on operational and client needs.

Employee Benefits & Perks:

- Health benefits (medical, dental, and vision) begin on Day 1 of employment.

- 401(k) with company match and additional benefits become available within the first few months.

- Employees can take advantage of the flexible vacation policy after 90 days of employment. Any exceptions require manager approval before the employee's start date at Gainwell.

- Career growth and advancement opportunities are encouraged and supported.

- A company-provided computer is supplied for work use.

The deadline to submit applications for this posting is November 16, 2026.

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The pay range for this position is $32,700.00 - $46,700.00 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.