Gainwell Technologies · 1 day ago
Senior Healthcare Payment Analyst
United States
Contract
Remote
Mid, Senior Level
$74K/yr - $106K/yr
5+ years expGainwell Technologies is a company dedicated to improving the health and well-being of vulnerable communities through innovative technology solutions. As a Senior Healthcare Payment Analyst, you will develop and implement data mining opportunities to identify healthcare overpayments and assist in optimizing payment processes. This role involves collaborating with various teams to enhance audit processes and ensure compliance with industry standards.
Health CareInformation Technology
Responsibilities
Develop and implement new data mining opportunities for identifying healthcare overpayments made to providers by insurance companies through data review and analytics
Act as a senior member of the team and help to assist lower-level analysts
Research industry standard guidelines, State/Federal regulations, and client billing and reimbursement policies, to develop and configure improper payment algorithms
Review provider contracts to identify algorithms for the identification of contractual based overpayments
Implement current Payment Analytics concepts for new and existing clients by ensuring client policy is supportive and properly applied
Support the appeals, validation, and client services team in resolving outstanding issues regarding production queries
Ensures individual and departmental goals are consistently met or exceeded, in collaboration with other team members and management
Reviews IT programming results for quality assurance and proof of concept validation
Documents query results and prepare internal and external documentation and presentations related to new overpayment issues
Works with internal operations and clinical teams to develop, implement, review and audit protocols and internal review guidelines
Works with engineers to develop and implement technological improvements that will support the audit process
Contributes new ideas for improving existing audit processes and audit queries
Qualification
Required
5+ years of experience in healthcare reimbursement, claims analysis, or revenue cycle improvement
Strong background in medical billing/coding, auditing, and provider contract development
Familiarity with CMS regulations, coding guidelines, and recovery audit practices
Ability to apply published healthcare guidelines to claims data
Benefits
Generous, flexible vacation policy
A 401(k) employer match
Comprehensive health benefits
Educational assistance
Variety of leadership and technical development academies
Company
Gainwell Technologies
Gainwell Technologies is a provider of Information Technology & Services. It is a sub-organization of Veritas Capital.
10001+ employees
H1B Sponsorship
Gainwell Technologies has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (90)
2024 (78)
2023 (56)
2022 (96)
2021 (33)
Funding
Current Stage
Late StageTotal Funding
$1M2023-06-06Grant· $1M
Leadership Team
Paul N. Saleh
President and Chief Executive Officer
Gary Call
Chief Medical Officer
Recent News
bloomberglaw.com
2025-12-12
GlobeNewswire
2025-12-11
Company data provided by crunchbase