Senior Business Analyst, Medical Coding – Policy

Gainwell Technologies

. Combine deep medical coding expertise with strong business analysis capability to support healthcare system operations and implementations .

Posted 6/27/2026full-timeRemote • 🇺🇸 United StatesSenior💰 $69,400 - $99,200 per yearWebsite

Tech Stack

Tools & technologies

SDLC

About the role

Key responsibilities & impact

Combine deep medical coding expertise with strong business analysis capability to support healthcare system operations and implementations
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 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
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

Requirements

What you’ll need

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)

Benefits

Comp & perks

generous, flexible vacation policy
educational assistance
comprehensive health benefits
401(k) employer match
leadership and technical development academies

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

medical codingbusiness analysisrequirements elicitationclaims processingbillingpolicy documentationSDLCPLCtestingvalidation

Soft Skills

communicationcollaborationdocumentationanalytical thinkingproblem-solvingcoordinationguidancestakeholder managementtranslating complex conceptsoperational alignment

Certifications

Certified Professional Coder (CPC)