Business Analyst - Healthcare

Role Description

As a Business Analyst - Healthcare at Gainwell, 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.

• Works collaboratively with the client and team members - both external and internal to the company - to research, validate and document business needs.
• Ensures that those needs are clearly reflected and completed.
• Assists with translating client requests and changes into the Medicaid Management Information System (MMIS).
• Helps determine solutions to business problems and effectively manages client’s expectations.
• Ensures that items are prepared for client meetings.
• Ensures Operating Procedure Manuals are updated as required.
• Works with the client on change requests, publications, and claim adjustments/reprocessing.
• Researches, identifies, and specifies solutions to problems.
• Documents updates for all reference updates/changes.
• Works with the systems team on any assigned system changes, meeting required timelines.
• Assists with quarterly and annual CPT, HCPCS, and diagnosis code updates in the system, ensuring rules are correct and working on edit and audit configuration.

Qualifications

• 3+ years as a Business Analyst with healthcare claims experience required.
• A Certified coder is preferred.
• Proficiency in CPT, HCPCS, and ICD-10 coding.
• Ability to work collaboratively in a team environment.
• Strong Excel skills.
• Excellent verbal and written communication skills with the ability to build strong working relationships.
• Ability to create and maintain manual documentation and support provider notifications.

Requirements

• Fully remote options from continental US locations only.
• Video cameras must be used during all interviews, as well as during the initial week of orientation.
• The deadline to submit applications for this posting is June 23, 2026.

Benefits

• Generous, flexible vacation policy.
• 401(k) employer match.
• Comprehensive health benefits.
• Educational assistance.
• Variety of leadership and technical development academies to help build your skills and capabilities.