Senior Business Analyst - Managed Care Entity

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 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 a Senior Business Analyst - Managed Care Entity 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. In this position you will work collaboratively with the client and team members-both external and internal to the company - to research, validate and document business needs, and to ensure that those needs are clearly reflected and completed. You will assist with translating client requests and changes into the MMIS and may help determine solutions to business problems. While effectively managing client’s expectations. Your role in our mission Play a critical part in ensuring Gainwell is meeting our clients’ objectives in important areas.

• Ensure that items are prepared for client/MCE meetings.
• Ensure Operating Procedure Manuals are updated as required
• Work with the client on claims research. change requests, and suspended claims
• Research, identify, and specify solutions to problems.
• Document creation and updates for projects.
• Assist with Managed Care Entity encounter meetings, questions and research

What We're Looking For

• 5+ years of Healthcare Claims experience
• Certified coder is a plus
• Good understanding of CPT, HCPCS and ICD-10 coding
• Hands - on experience with Encounter Claims (shadow billing), required to track and follow EC mailbox.
• Must be proficient in Excel

Knowledge & Skills

• Must work collaboratively in a team environment.
• Build relationships and working collaboratively internally and externally
• Effective verbal/ written communication.
• Ability to assist/create manual documentation as well as provider notifications

What You Should Expect In This Role

• Fully remote options from continental US locations only
• 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 February 10, 2026

Claims

• 10 coding

The pay range for this position is $69,400.00 - $99,200.00 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.