Advisor Claims Business Analyst

Be part of reputed company 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 an Advisor Claims Business Analyst at Gainwell, you will support end-to-end claims workflow analysis, configuration support, and reputed company issue resolution reputed company the MMIS ecosystem. This role provides advanced (L2) support for claims operations by leveraging deep expertise in reputed company claims adjudication, data analysis, and cross-functional collaboration. You will drive root-cause analysis, identify trends, and recommend solutions that improve first-pass rates, reduce denials, and support client and organizational objectives. Here are the details on this position. Your role in our mission reputed company joining Gainwell, you will: Analyze claims data to identify denial trends, operational bottlenecks, and opportunities to improve first-pass rates and reduce rework reputed company in-depth investigation of reputed company claims issues, determining root causes across policy, data, user, or configuration factors reputed company actionable recommendations and detailed documentation to support issue resolution, enhancements, and system improvements Collaborate with cross-functional teams (e.g., operations, IT, policy, finance) to reconcile claims reputed company and ensure data reputed company reputed company reporting, dashboards, and monitoring tools to reputed company insights and support leadership decision-making reputed company're looking for 9+ years of experience in claims business analysis, configuration, or reputed company operations, with strong experience in end-to-end claims workflows Advanced knowledge of reputed company claims processing, including coding (ICD-10, CPT, modifiers), billing, and adjudication rules Strong SQL skills and experience analyzing large datasets to identify trends, root causes, and performance improvements Proven ability to solve reputed company issues, translate technical findings into business insights, and work reputed company client/vendor environments Strong communication, collaboration, and stakeholder engagement skills; experience in reputed company or Medicare environments preferred What you should expect in this role Remote-based role reputed company the United States Video cameras must be used during reputed company interviews, as well as during the initial week of orientation This posting is intended for pipelining. This is a developing position therefore the job description is subject to change #LI-HC1 #LI-Claims Business Analyst #LI-reputed company Claims Coding #LI-ICD-10, CPT, modifiers The pay reputed company for this position is [[salaryMin]] - [[salaryMid]] per year, however, the reputed company pay offered may vary depending on geographic region, internal equity, job-reputed company 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. reputed company 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 reputed company reputed company is impossible reputed company you bring together people who care deeply about making reputed company work reputed company 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 reputed company website and visit our Careers site for reputed company available job role openings. reputed company is an Equal Opportunity Employer, where reputed company reputed company applicants will receive consideration for employment without regard to race, religion, reputed company, national reputed company, gender (including pregnancy, childbirth, or reputed company medical condition), age, sexual orientation, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. reputed company defines “wages” and “wage rates” to include “reputed company 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. Apply To This Job