Senior Healthcare Analytics & Claims Analyst - Remote

Gainwell Technologies; Town of Texas (WI); Hybrid; USD 69,000 - 99,000; Full time

Benefits offered by this job

Generous vacation policy

Educational assistance

401(k) employer match

Health benefits

Job summary

HMS, a Gainwell Company, is seeking a Senior Business Analyst to help clients improve health outcomes through data and technology. You’ll post payments, reconcile accounts, analyze claims, and document requirements in collaboration with client teams.

Fully remote option from most US locations, you’ll join a results-driven group that values flexibility, learning, and career development while delivering impactful healthcare solutions.

Qualifications

• Bachelor’s degree in Business, Healthcare Administration, Finance, or 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.

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.

Skills

SQL proficiency

Data analysis

Critical thinking

Problem solving

Communication

Attention to detail

Organizational skills

Education

Bachelor’s degree or 3–5 years experience in medical claims posting

Tools

PeopleSoft Finance

Job description

HMS, a Gainwell Company, is seeking a Senior Business Analyst to help clients improve health outcomes through data and technology. You’ll post payments, reconcile accounts, analyze claims, and document requirements in collaboration with client teams.

Fully remote option from most US locations, you’ll join a results-driven group that values flexibility, learning, and career development while delivering impactful healthcare solutions.