Great companies need great teams to propel their operations. Join the group that solves business challenges and enhances the way we work and grow. Working at Gainwell carries its rewards. You'll have an incredible opportunity to grow your career in a company that values your contributions and puts a premium on work flexibility, learning, and career development.
SummaryAs a
Senior Business Analyst - Healthcare Claims - MMIS 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 - Ensure that items are prepared for client meetings.
- Ensure Operating Procedure Manuals are updated as required
- Work with the client on change requests, publications and claim adjustments/reprocessing
- Research, identify, and specify solutions to problems.
- Document updates for all reference updates/changes.
- Work with the systems team on any assigned system changes, meeting required timelines
- Assist with quarterly and annual CPT, HCPCS and diagnosis code updates in the system, ensuring rules are correct and working on edit and audit configuration.
What we're looking for - 5+ years as a Business Analyst with healthcare claims experience required
- Must be proficient in Excel
- Certified coder is a plus
- Proficient in CPT, HCPCS and ICD-10 coding
- Must work collaboratively in a team environment in making changes to the reference system for CPT, HCPCS and ICD-10 coding updates and benefit plan coverage.
- Build relationships and working collaboratively; 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
- This posting is intended for pipelining. This is a developing position therefore the job description is subject to change.
#LI-HC1
#LI-Healthcare Claims
LI-Certified Coder
The pay range for this position is $ 69,400 - $99,200 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.
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