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Business Analyst - Medicaid Claims
Location
United States
Posted
74 days ago
Salary
$55.6K - $79.4K / year
Seniority
Mid Level
No structured requirement data.
Job Description
Business Analyst - Medicaid Claims
Gainwell Technologies
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 a Business Analyst - Medicaid Claims 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. Here are the details on this position. You will support the Claims and Reference functional areas of the Arkansas Title XIX fiscal agent account. This position will be assigned to coordinate the system modifications and enhancements related to Claims/Reference/Business Processing Application (BPA). A knowledge of procedure codes, diagnosis codes, benefit plans, and rules engine functionality are a plus. Here are the details on this position. Your role in our mission Take charge and focus on how we can meet critical needs to help clients deliver better health and human services outcomes. - Coordinate workstreams and teams on IT projects to align solutions with client business priorities - Demonstrate your knowledge as SME and liaison for clients and internally between technical and non-technical workers to transform requirements into real results - Delegate work across teams, and coach and monitor project team members to plan, design, and improve complex business processes and modifications - Streamline workflows across clients and technical personnel to determine, document, and oversee carrying out system requirements - Support quality control as you create and execute test cases to verify that all requirements have been met What we're looking for - 3 or more years of experience working as a business analyst between technical and non-technical personnel, with Medicaid and Medicare experience preferred. - Experienced in claims processing with a strong focus on policy-driven outcomes and compliance with regulatory standards. Experience and knowledge with HCPCS and ICD procedure codes and ICD diagnosis code is a plus - Familiarity with HIPAA EDI X12 transaction sets, particularly 837 (Claims) - Knowledge of Microsoft Excel advanced features such as macros and core functions. Experience with relational database software and SQL is a plus - Ability to clearly and concisely translate technical requirements to a non-technical audience - Skills working with business processes and re-engineering - Curiosity to solve complex problems and strong interpersonal skills to interact with and influence clients and team members - A caring team leader who motivates and coaches less experienced resources What you should expect in this role - Fully remote, only US location options will be considered - Client is in Central time zone - 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 April 8, 2026 #LI-HC1 #LI-EDI X12 #LI-EDI 837 Claims #LI-HCPCS 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 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.
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