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Claims Healthcare Business Analyst

Date:  Sep 15, 2023

Indianapolis, IN, US, 46204-1077 Any city, IN, US, 99999 Any city, TX, US, 99999 Any city, KS, US, 99999

Req ID:  19288

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. 



As a Claims Healthcare Business Analyst 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.

Your role in our mission

Gainwell empowers you show you’re a pro and help clients deliver better health and human services outcomes using innovative technology and solutions.

  • Analyze, plan, design, document and make recommendations to improve business processes to support client’s technological aspirations and ensure that items are prepared for client meetings. 
  • Be a supportive bridge between clients, project managers and technical personnel to define, track and communicate business requirements and their expected impact by building basic conceptual data and process models
  • Create, execute or analyze basic test scenarios to verify that client requirements are built into system design. Work with the client on change requests, publications and claim adjustments/reprocessing 
  • Ensure that “intent of change” is carried out through every project phase by participating in technical reviews and inspections.
  • 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. Certified coder is a plus.

What we're looking for

  • Five or more years of healthcare claims experience.
  • Must work collaboratively in a team environment in making changes to the reference system for CPT, HCPCS and ICD-10 coding updates and benefit plan coverage.
  • Advanced knowledge in Microsoft Excel and other software for conducting quantitative analysis 
  • Strong analytical and business process re-engineering skills
  • Strong written and oral communication and presentation skills to deliver messages to business leaders, clients and technical personnel
  • An influencer and team player who that motivates others to action and communicates key technical ideas in a digestible way 

What you should expect in this role

  • Fully remote opportunity 
  • Video cameras must be used during all interviews, as well as during the initial week of orientation.
  • #LI-NR1
  • #LI-Remote


The pay range for this position is $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. 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 committed to a diverse, equitable, and inclusive workplace. We are proud to be 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), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. We celebrate diversity and are dedicated to creating an inclusive environment for all employees.

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