[Hiring] Senior Business Analyst, Medical Coding & Policy @Gainwell Technologies LLC

Role Description

As a Senior Business Analyst, Medical Coding & Policy at Gainwell, you will combine deep medical coding expertise with strong business analysis capability to support healthcare system operations and implementations. In this role, you will act as a bridge between operational areas, delivery teams, and client stakeholders, ensuring that coding, billing, and policy requirements are clearly defined, accurately implemented, and well documented.

• Play a key role in delivering high-quality business analysis and operational support across both functional area maintenance and project initiatives.
• Develop and own structured solution artifacts and operational deliverables that define coding, billing, or policy-related changes, driving them end-to-end from initial definition through review, coordination, testing alignment, implementation, and closure.
• Elicit, document, and manage business, functional, and operational requirements, translating complex medical coding and billing concepts into clear, actionable deliverables.
• Author and maintain claims processing instructions, policy documentation, and operational guidance in clear, plain language to support both internal teams and client stakeholders.
• Analyze coding, billing, and claims-related processes and system impacts, ensuring alignment across functional areas and with technical solutions.
• Serve as a bridge between operations, Business Analysts, and delivery teams, ensuring consistent understanding and application of coding and policy requirements.
• Participate in and support requirements workshops, design sessions, operational discussions, and client walkthroughs.
• Ensure adherence to established standards, templates, and documentation practices across all deliverables.
• Maintain project coordination and communication activities, including capturing and distributing meeting outcomes, tracking status of work items, and providing updates to Project Managers, Business Leads, and stakeholders.
• Provide guidance to other BAs and functional teams on coding, billing, and policy-related topics, strengthening consistency across the team.

Qualifications

• Six or more years of experience as a Business Analyst, coding analyst, or in a related healthcare role.
• Certified Professional Coder (CPC) or equivalent deep medical coding expertise (required).
• Experience supporting healthcare or Medicaid claims processing, coding, or related system implementations (required).
• Strong knowledge of requirements elicitation and writing, SDLC/PLC processes, and alignment of requirements to testing and validation activities.
• Experience working across functional areas such as claims, billing, policy, and operations.
• Sufficient technical aptitude to understand system and claims processing impacts (not a development role).

Requirements

• Proven experience developing clear, structured requirements, claims processing instructions, policy documentation, or operational guidance.
• Strong ability to translate complex coding, billing, and policy concepts into clear, plain-language documentation.
• Strong communication skills with the ability to engage directly with client stakeholders and influence outcomes.
• Strong attention to detail and ability to produce high-quality deliverables with minimal rework.
• Ability to work independently while collaborating effectively across operational and delivery teams.

Benefits

• Generous, flexible vacation policy.
• 401(k) employer match.
• Comprehensive health benefits.
• Educational assistance.
• Leadership and technical development academies to help build your skills and capabilities.