Senior Business Analyst, Medical Coding – Policy

🕒 3 days ago

🇺🇸 United States – Remote

💵 $69.4k - $99.2k / year

⏰ Full Time

🟠 Senior

🧐 Business Analyst

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Gainwell Technologies

WebsiteLinkedInAll Job Openings

10,000+ employees

⚕️ Healthcare Insurance

💰 Grant on 2023-06

Healthcare Insurance • Human Services • Healthcare

Gainwell Technologies is the nation’s leading provider of digital and cloud-enabled solutions across the human services and public health ecosystem. With a mission-driven approach, Gainwell serves clients in all 50 U. S. states, focusing on improving health outcomes and delivering intuitive, human-centered experiences. Their comprehensive suite of solutions includes Medicaid Enterprise modernization, data analytics, provider services, and pharmacy solutions, all designed to advance the future of healthcare and enhance community well-being.

📋 Description

• Combine deep medical coding expertise with strong business analysis capability to support healthcare system operations and implementations • Act as a bridge between operational areas, delivery teams, and client stakeholders, ensuring that coding, billing, and policy requirements are clearly defined, accurately implemented, and well documented • Play a key role in strengthening alignment between functional areas and delivery, translating complex concepts into clear, actionable guidance that supports both system solutions and day-to-day operations for Medicaid programs • Develop and own structured solution artifacts and operational deliverables that define coding, billing, or policy-related changes, driving them end-to-end from initial definition through review, coordination, testing alignment, implementation, and closure • Elicit, document, and manage business, functional, and operational requirements, translating complex medical coding and billing concepts into clear, actionable deliverables • Author and maintain claims processing instructions, policy documentation, and operational guidance in clear, plain language to support both internal teams and client stakeholders • Analyze coding, billing, and claims-related processes and system impacts, ensuring alignment across functional areas and with technical solutions • Serve as a bridge between operations, Business Analysts, and delivery teams, ensuring consistent understanding and application of coding and policy requirements • Participate in and support requirements workshops, design sessions, operational discussions, and client walkthroughs • Ensure adherence to established standards, templates, and documentation practices across all deliverables • Maintain project coordination and communication activities, including capturing and distributing meeting outcomes, tracking status of work items, and providing updates to Project Managers, Business Leads, and stakeholders • Provide guidance to other BAs and functional teams on coding, billing, and policy-related topics, strengthening consistency across the team

🎯 Requirements

• Six or more years of experience as a Business Analyst, coding analyst, or in a related healthcare role • Certified Professional Coder (CPC) or equivalent deep medical coding expertise (required) • Experience supporting healthcare or Medicaid claims processing, coding, or related system implementations (required) • Strong knowledge of requirements elicitation and writing, SDLC/PLC processes, and alignment of requirements to testing and validation activities • Experience working across functional areas such as claims, billing, policy, and operations • Sufficient technical aptitude to understand system and claims processing impacts (not a development role)

🏖️ Benefits

• generous, flexible vacation policy • educational assistance • comprehensive health benefits • 401(k) employer match • leadership and technical development academies