Senior Business Analyst

Gainwell Technologies LLC•Any city, OH

17d•$69,400 - $99,200•Remote

About The Position

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 HMS, a Gainwell Company 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. As a Senior 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. Here are the details on this position. Your role in our mission Play a critical part in ensuring Gainwell is meeting our clients’ objectives in important areas.

Requirements

Bachelor’s degree in Business, Healthcare Administration, Finance, or a related field; OR 3–5 years of experience in medical claims posting and reconciliation.
Solid understanding of medical and pharmacy claims adjudication and Medicaid reclamation claims.
Proficiency in SQL and ability to extract and analyze data from relational databases.
Familiarity with PeopleSoft Finance or similar enterprise financial systems.
Strong critical thinking and problem-solving skills; able to troubleshoot independently.
Experience with FTP protocols and secure file transfer.
Excellent written and verbal communication skills.
Strong attention to detail and organizational skills.

Responsibilities

Post payments to medical and pharmacy claims from paper and electronic EOBs daily.
Reconcile AR and correct any discrepancies or posting issues.
Identify, analyze, and resolve errors in claim postings and payments.
Participates in meetings with client engagement to gather and document requirements and explore potential solutions.
Assists in analyzing and documenting client's business requirements and processes following established approach and methodology; communicates these requirements to technical personnel.
Reconcile AR and correct any discrepancies or posting issues.
Identify, analyze, and resolve errors in claim postings and payments.
Participates in meetings with client engagement to gather and document requirements and explore potential solutions.
Assists in analyzing and documenting client's business requirements and processes following established approach and methodology; communicates these requirements to technical personnel