Senior Business Analyst, Medical Coding & Policy

Senior Business Analyst, Medical Coding & Policy

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 Gainwell 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, 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. You will play a key role in strengthening alignment between functional areas and delivery, translating complex concepts into clear, actionable guidance that supports both system solutions and day-to-day operations for Medicaid programs.

Your role in our mission 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

What we're looking for 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) Professional Skills 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

What you should expect in this role Significant collaboration with operations teams, Business Analysts, and technical delivery teams Regular engagement with client stakeholders (DHS) on coding, policy, and operational alignment Opportunity to serve as a key bridge between business operations and system delivery Work Environment Fully remote opportunity from most US locations Work must be performed from within the contiguous United States (48 states) Limited travel (0–5%), depending on project and operational needs (though unlikely) Video cameras must be on during all interviews, internal, and client-facing meetings Working hours aligned to core business hours: 7:30 AM – 4:30 PM CST