Senior Business Analyst

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.

Summary

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.

• 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

What we're looking for

• 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.

What you should expect in this role

• Fully remote opportunity from most US locations
• 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

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 HMS, a Gainwell Company. 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 HMS, a Gainwell Company, an industry leader. You’ll be joining a company where collaboration, innovation, and inclusion fuel our growth. Learn more about HMS, A Gainwell Technologies Company at our company website and visit our Careers site for all available job role openings.

HMS, a Gainwell Company, 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. HMS 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.