Experienced Claims Business Analyst

Gainwell Technologies

Experienced Claims Business Analyst at Gainwell Technologies analyzing and resolving complex claims workflows. Supporting Medicaid claims adjudication and collaborating with cross-functional teams.

Posted 7/3/2026full-timeRemote • Texas • 🇺🇸 United StatesSeniorLead💰 $86,800 - $124,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Expertise in healthcare claims analysis, including advanced knowledge of coding, billing, and adjudication rules, combined with strong SQL skills for data analysis. Proven ability to collaborate with cross-functional teams to resolve complex claims issues and provide actionable insights for system improvements.

Highest-signal resume keywords

Healthcare Claims ProcessingSQL Data AnalysisICD-10 CodingCPT CodingMedicaid or Medicare Experience

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims Data AnalysisRoot Cause AnalysisReporting DevelopmentDashboard CreationOperational Bottleneck Identification

Soft Skills

Strong CommunicationCollaboration SkillsProblem Solving

Tools & Technologies

Monitoring Tools

Industry Keywords

Healthcare OperationsClaims Adjudication RulesBillingDenial Trends

Tech Stack

Tools & technologies

SQL

About the role

Key responsibilities & impact

Analyze claims data to identify denial trends and operational bottlenecks
Perform in-depth investigation of complex claims issues, determining root causes
Provide actionable recommendations to support issue resolution, enhancements, and system improvements
Collaborate with cross-functional teams to reconcile claims outcomes
Develop reporting, dashboards, and monitoring tools for leadership decision-making

Requirements

What you’ll need

9+ years of experience in claims business analysis, configuration, or healthcare operations
Advanced knowledge of healthcare claims processing, including coding (ICD-10, CPT, modifiers), billing, and adjudication rules
Strong SQL skills and experience analyzing large datasets
Proven ability to solve complex issues and translate technical findings into business insights
Strong communication and collaboration skills; experience in Medicaid or Medicare environments preferred

Benefits

Comp & perks

Health benefits
401(k) employer match
Flexible vacation policy
Educational assistance
Leadership and technical development academies