Senior Healthcare QA Rep - Remote US

It takes great medical minds to create powerful solutions that solve some of healthcare’s most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you’ve honed your career in a fast-moving medical environment. While Gainwell operates with a sense of urgency, you’ll have the opportunity to work more flexible hours. And working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values work-life balance, continuous learning, and career development.

Summary

Gainwell Technologies is seeking an experienced Sr. Healthcare Quality Assurance professional to support quality assurance, auditing, and financial operations within a healthcare environment. This role combines healthcare knowledge, financial and operational auditing, data analysis, and hands-on SQL experience to evaluate processes, identify discrepancies, ensure compliance, and support continuous improvement.

The ideal candidate brings strong analytical skills, healthcare industry experience, knowledge of medical terminology, and the ability to independently research and resolve complex operational and financial issues. This position is remote within Ohio with required onsite attendance at our Ohio Office approximately 2 times per month; onsite frequency may vary based on business needs.

Your role in our mission

• Perform quality assurance and audit activities across healthcare financial operations, including accounts receivable/payable, capitation, credit balances, cost settlements, recoveries, and related processes.
• Review financial transactions, healthcare data, reports, and supporting documentation to identify discrepancies and ensure accuracy and compliance with established controls.
• Use SQL to query, extract, review, and analyze data in support of audits, reporting, research, reconciliation, and operational analysis.
• Create, maintain, and update audit procedures, control documentation, operational processes, and client-required reporting.
• Research complex financial and operational issues, recommend process improvements, and serve as a resource to team members on quality, audit, and operational requirements.

What we're looking for

• Bachelor’s degree or equivalent combination of education and relevant professional experience in quality assurance, auditing, finance, accounting, financial analysis, or a related function.
• Healthcare industry experience, preferably within Medicaid, Medicare, managed care, health insurance, claims, or government healthcare programs.
• One to two years of hands-on SQL experience, including querying, extracting, reviewing, and analyzing data.
• Working knowledge of medical terminology with experience interpreting healthcare-related data, claims, documentation, and operational information.
• Knowledge of financial controls and accounting principles, including GAAP and/or SOX, with strong analytical, research, problem-solving, and communication skills.

What you should expect in this role

• This position is remote within Ohio with required onsite attendance at our Ohio Office (5475 Rings Road Atrium II, North Tower, Suite 125 Dublin, OH 43017) approximately 2 times per month; onsite frequency may vary based on business needs.
• Comprehensive benefits for eligible employees, including medical, dental, and vision coverage.
• Access to a 401(k) retirement savings plan and additional employee wellness and financial benefits.
• Paid time off and paid holidays to support work-life balance.
• Opportunities for professional development and career growth within Gainwell Technologies.

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The pay range for this position is $50,400.00 - $72,000.00 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.