Note: The job is a remote job and is open to candidates in USA. Gainwell Technologies is hiring an Early Career Business Analyst - Operations to support healthcare claims and payment operations. The role posts payments, reconciles accounts receivable, resolves discrepancies, generates invoices and reports, and documents business requirements and processes.

Responsibilities

• 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
• Plans and designs standard business processes following established approach and methodology; assists in formulating recommendations to improve and support business activities
• Develops and modifies 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)

Skills

• Strong problem-solving skills
• Experience in healthcare claims
• Deep understanding of medical and pharmacy claims adjudication, Medicaid reclamation, and healthcare payment cycles
• 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
• Experience working with healthcare data analytics or reporting tools
• Knowledge of healthcare payment cycles and insurance reimbursement processes

Benefits

• Fully remote options from Contiguous US locations only
• Generous, flexible vacation policy
• 401(k) employer match
• Comprehensive health benefits
• Educational assistance
• Comprehensive leadership and technical development academies

Company Overview

Company H1B Sponsorship