[Hiring] Early Career Business Analyst - Operations @Gainwell Technologies LLC

Role Description

As an Early Career Business Analyst - Operations 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. Here are the details on this position.

• 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.
• Participate in meetings with client engagement to gather and document requirements and explore potential solutions.
• Assist in analyzing and documenting client's business requirements and processes following established approach and methodology; communicate these requirements to technical personnel.
• Plan and design standard business processes following established approach and methodology; assist in formulating recommendations to improve and support business activities.
• Develop and modify systems requirements documentation to meet client needs.
• Generate and distribute monthly invoices using PeopleSoft Finance based on claims posted during the reporting period.
• Create, run, and deliver posting and reconciliation reports; analyze trends and anomalies.
• Use FTP protocols to securely transfer files from various sources.
• Maintain accurate documentation for audit and compliance purposes.
• Collaborate with other departments to resolve issues related to claims and payments.
• Work independently in a remote environment while meeting deadlines and service level agreements (SLAs).

Qualifications

• 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.

Requirements

• Experience working with healthcare data analytics or reporting tools (preferred).
• Prior experience in a remote or hybrid work environment (preferred).
• Knowledge of healthcare payment cycles and insurance reimbursement processes (preferred).

Benefits

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

Company Description

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.