Business Analyst - Healthcare

Business Analyst - Healthcare Location: Any city, IN, US, 99999 Work Mode: Virtual (Exception only) Be part of a team that unleashes the power of leading‑edge technologies to help improve the health and well‑being of those most vulnerable in our country and communities. Working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values work flexibility, learning, and career development. You’ll add to your technical credentials and certifications while enjoying a generous, flexible vacation policy and educational assistance. We also have comprehensive leadership and technical development academies to help build your skills and capabilities. Summary 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, and to ensure that those needs are clearly reflected and completed. Assists with translating client requests and changes into the MMIS and may help determine solutions to business problems. Effectively manages client’s expectations. Here are the details on this position. Your role in our mission Gainwell empowers you to show you’re a pro and help clients deliver better health and human services outcomes using innovative technology and solutions. Ensure that items are prepared for client meetings. Ensure Operating Procedure Manuals are updated as required. Work with the client on change requests, publications and claim adjustments/reprocessing. Research, identify, and specify solutions to problems. Document updates for all reference updates/changes. Work with the systems team on any assigned system changes, meeting required timelines. Assist with quarterly and annual CPT, HCPCS and diagnosis code updates in the system, ensuring rules are correct and working on edit and audit configuration. What we're looking for 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, including making updates to reference systems for coding (CPT, HCPCS, ICD-10) and benefit plan coverage. 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. What you should expect in this role 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. Pay range: $55,600.00 - $79,400.00 per year, however, the base pay offered may vary depending on geographic region, internal equity, job‑related knowledge, skills, and experience among other factors. 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. 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. #J-18808-Ljbffr