Bangalore South, Karnataka, India · Remote Solely
Summary As a Business Analyst - Healthcare Reference at Gainwell, you will contribute to healthcare technology delivery by analyzing business needs, documenting requirements, and supporting solutions involving healthcare…
Skills: Business Analysis, Healthcare Claims Processing, ICD-10, CPT, HCPCS
Bangalore South, Karnataka, India · Remote OK
Summary As a Business Analyst – Healthcare Reference, you will contribute to healthcare technology delivery by analyzing business needs, documenting requirements, and supporting solutions involving healthcare reference c…
Skills: Business Analysis, Healthcare Reference Data, ICD-10, CPT, HCPCS
Bangalore South, Karnataka, India · Remote Solely
Summary As an Business Analyst - Content & Document Management (Infra) 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 member…
Skills: SQL, C3M, IBM FileNet, IBM CMOD, Business Analysis
Williston, Vermont, United States · Hybrid
$44k–$63k/yr
Great companies need great teams to propel their operations. Join the group that solves business challenges and enhances the way we work and grow. Working at Gainwell carries its rewards. You’ll have an incredible opport…
Skills: Financial Reporting, Medical Claims Processing, Accounts Receivable, Accounts Payable, Microsoft Excel
Montgomery, Alabama, United States · On-site
$45k–$65k/yr
Great companies need great teams to propel their operations. Join the group that solves business challenges and enhances the way we work and grow. Working at Gainwell carries its rewards. You’ll have an incredible opport…
Skills: Team Leadership, Performance Monitoring, Coaching And Development, Quality Assurance, Conflict Resolution
Montgomery, Alabama, United States · On-site
$27k–$39k/yr
Great companies need great teams to propel their operations. Join the group that solves business challenges and enhances the way we work and grow. Working at Gainwell carries its rewards. You’ll have an incredible opport…
Skills: Customer Service, Call Center Operations, Problem Resolution, Medicaid Eligibility Support, Claims Processing
Perry County, Ohio, United States · Remote OK
$119k–$170k/yr
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 h…
Skills: Application Architecture, Enterprise Architecture, TOGAF, Cloud Technologies, Software Development Lifecycle
Tada, Andhra Pradesh, India · Remote Solely
Summary As a Software Technical Writer creates clear, accurate, and user-friendly documentation for software products. This role involves working closely with developers, product managers, and QA teams to translate compl…
Skills: Technical Writing, XML, Oxygen, Perforce, Git
Perry County, Ohio, United States · Remote OK
$56k–$79k/yr
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 h…
Skills: Healthcare Claims, CPT Coding, HCPCS Coding, ICD-10 Coding, Microsoft Excel
Bangalore South, Karnataka, India · On-site
Summary As a Senior Data Scientist, you will support Gainwell’s Medicaid and public sector analytics initiatives by leading advanced data science activities across complex healthcare and enterprise datasets. The role foc…
Skills: SQL, Python, Machine Learning, Statistical Modeling, Databricks
Perry County, Ohio, United States · Remote OK
$86k–$124k/yr
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 h…
Skills: Project Management, Program Management, Operational Readiness, Stakeholder Communication, Risk Management
Bangalore South, Karnataka, India · On-site
Summary As a PowerBuilder Developer, you will be responsible for designing, developing, testing, and supporting enterprise applications using PowerBuilder and related technologies. The role involves working across front-…
Skills: Power Builder, Software Design, SDLC, Technical Documentation, Component-Level Design
Bangalore South, Karnataka, India · Remote OK
Summary As a Quality Improvement Specialist, you will support Gainwell delivery organizations by performing quality assurance, governance, and continuous improvement activities aligned with Gainwell Quality Standards, CM…
Skills: CMMI for Development and Services, Quality Assurance, Process Auditing, Root Cause Analysis, Quality Metrics Analysis
Bangalore South, Karnataka, India · Remote Solely
Summary As a PowerBuilder Developer, you will be responsible for designing, developing, testing, and supporting enterprise applications using PowerBuilder and related technologies. The role involves working across front-…
Skills: PowerBuilder 2022, UI Development, Backend Logic, MS SQL Server, Oracle
Bangalore South, Karnataka, India · Remote OK
Summary As an Business Analyst (Content & Document Management / Infra) 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 member…
Skills: SQL, C3M, IBM FileNet, IBM CMOD, Business Analysis
Perry County, Ohio, United States · Remote OK
$69k–$99k/yr
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 h…
Skills: Project Management, SDLC, Waterfall Methodology, Hybrid Methodology, MMIS
Muskingum County, Ohio, United States · Remote OK
$106k–$152k/yr
It takes great medical minds to create powerful solutions that solve some of healthcare’s most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you’ve honed your car…
Skills: Pharmacy Benefit Management, Clinical Prior Authorization, Medicaid Requirements, Therapeutic Class Review, Drug Utilization Review
Perry County, Ohio, United States · Hybrid
Great companies need great teams to propel their operations. Join the group that solves business challenges and enhances the way we work and grow. Working at Gainwell carries its rewards. You’ll have an incredible opport…
Skills: Subrogation, Claims Recovery, Case Management, HIPAA Compliance, Legal Review
Muskingum County, Ohio, United States · Remote Solely
$131k–$187k/yr
Great companies need great teams to propel their operations. Join the group that solves business challenges and enhances the way we work and grow. Working at Gainwell carries its rewards. You’ll have an incredible opport…
Skills: Account Management, P&L Management, Service Delivery, Sales Strategy, Project Management
Bangalore South, Karnataka, India · Remote OK
Summary As a SharePoint Administrator – SharePoint & Project Server (AWS), you will be responsible for administering, supporting, and maintaining enterprise SharePoint Server and Project Server (PWA) environments hosted …
Skills: SharePoint Server, Project Server, AWS, PowerShell, SQL Server
Bangalore South, Karnataka, India • Remote Solely
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Analyze and document business requirements for healthcare claims and reference code sets to bridge the gap between stakeholders and technical teams. Perform impact analysis on regulatory updates and support testing activities to ensure system alignment.
Requires 6-10 years of experience as a Business Analyst with deep expertise in healthcare domains and specific code sets like ICD, CPT, and HCPCS. Proficiency in SDLC processes, requirements documentation, and data analysis tools is essential.
As a Business Analyst - Healthcare Reference at Gainwell, you will contribute to healthcare technology delivery by analyzing business needs, documenting requirements, and supporting solutions involving healthcare reference code sets and claims data. You will act as a bridge between business stakeholders, coding/policy experts, and technical teams to translate operational needs into clear and actionable requirements. This role is strictly involved in business analysis, requirements documentation, and healthcare reference data support activities and does not involve direct access to Protected Health Information (PHI), Personally Identifiable Information (PII), or any secured or confidential client data. The work is limited to analysis of healthcare claims, reference code sets, and system configurations using governed datasets and does not include handling or processing of sensitive health or personal information
• Analyze, design, and document business requirements related to healthcare claims, reference data, and code sets
• Work with stakeholders to gather and define requirements involving ICD, CPT, HCPCS, UB‑04, revenue codes, provider taxonomy, and other healthcare reference data
• Develop and maintain business analysis artifacts such as BRDs, functional specifications, process flows, decision tables, and traceability matrices
• Translate business, policy, and coding requirements into clear functional objectives for technical teams
• Perform impact analysis for code‑set changes, regulatory updates, and policy changes across claims processing systems
• Support testing activities, including defining test scenarios and validating system outputs
• Participate in technical reviews and project discussions to ensure requirement alignment across lifecycle phases
• Identify opportunities for business process improvement and data governance enhancements
• Collaborate with developers, testers, and stakeholders for issue resolution, defect triage, and root‑cause analysis
• Communicate effectively with business and technical teams through documentation, meetings, and presentations
• Experience with MMIS systems or healthcare program implementations
• Knowledge of HIPAA transactions and X12 claims (837, 835, etc.)
• Experience with SQL for data analysis and validation
• Familiarity with ALM tools, Jira, ServiceNow, or similar platforms
• Experience with data governance, reference‑data management, or claims edits/billing rules
• Exposure to regulatory compliance and healthcare audits
• Business analysis certifications or healthcare coding knowledge
Remote work environment with shift time (2 pm -11pm IST)
The people who build careers at Gainwell Technologies share one thing: they want their work to matter. Here, it does. We're the essential ingredient that makes Medicaid work. For more than 50 years, we've combined our sweeping scale and technology to turn complex policies into thriving programs. We act as the crucial connection bringing the U.S. healthcare ecosystem together, and we partner with state agencies to modernize public health. Our solutions translate complex member data into meaningful action. We streamline administration, connect vital systems, and drive efficiency. This gives providers more time to focus on delivering quality care to the people who need it most. When we bring Medicaid touchpoints to life, members thrive. From fighting fraud and recovering improper payments to speeding up verifications, every solution we deploy expands what's possible for the future of healthcare. Less burden, more mission. Gainwell.
Offices: United States, US
The people who build careers at Gainwell Technologies share one thing: they want their work to matter. Here, it does. We're the essential ingredient that makes Medicaid work. For more than 50 years, we've combined our sweeping scale and technology to turn complex policies into thriving programs. We act as the crucial connection bringing the U.S. healthcare ecosystem together, and we partner with state agencies to modernize public health. Our solutions translate complex member data into meaningful action. We streamline administration, connect vital systems, and drive efficiency. This gives providers more time to focus on delivering quality care to the people who need it most. When we bring Medicaid touchpoints to life, members thrive. From fighting fraud and recovering improper payments to speeding up verifications, every solution we deploy expands what's possible for the future of healthcare. Less burden, more mission. Gainwell.
Offices: United States, US
