Lead Medical Claims Research Analyst

Gainwell Technologies

. Provide functional leadership and day-to-day guidance to the Research Analyst team .

Posted 10/3/2026full-timeCalifornia • United StatesSenior💰 $70,000 - $80,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in healthcare operations and medical claims processing, with a strong focus on problem-solving, process improvement, and team leadership. Proven ability to collaborate with diverse stakeholders and ensure compliance with healthcare regulations.

Highest-signal resume keywords

Healthcare Operations ExperienceMedical Claims ProcessingFunctional LeadershipAnalytical SkillsProcess Improvement

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Medical Claims ProcessingResearch SkillsProblem-Solving SkillsBusiness Process AssessmentOperational Analysis

Soft Skills

Interpersonal SkillsOrganizational SkillsDecision-Making SkillsCollaboration SkillsPresentation Skills

Tools & Technologies

Business SystemsKnowledge Management Resources

Industry Keywords

Medi-CalMedicaidHealthcare RegulationsProvider OperationsCustomer Support Practices

About the role

Key responsibilities & impact

Provide functional leadership and day-to-day guidance to the Research Analyst team
Support complex inquiries, escalations, claims research, and correspondence
Investigate and resolve routine to highly complex medical claims, provider, client, and operational inquiries
Collaborate with providers, clients, leadership, and cross-functional business partners to resolve escalated issues
Support program initiatives and ensure compliance with applicable requirements
Contribute to knowledge management resources and develop best practices
Support staff training and mentoring
Document complex issue resolution and operational guidance
Identify process improvement opportunities and analyze operational trends
Recommend solutions to improve efficiency, service delivery, customer satisfaction, and business outcomes

Requirements

What you’ll need

Three or more years of experience in healthcare operations, medical claims processing, provider support, customer service, business process outsourcing, research, or a related field
Medi-Cal or Medicaid experience preferred
Demonstrated functional lead experience with the ability to provide direction, coaching, mentoring, and support within a team environment
Strong analytical, research, problem-solving, organizational, and decision-making skills
Excellent written, verbal, interpersonal, presentation, and facilitation skills
Ability to collaborate effectively with providers, clients, leadership, and cross-functional teams
Experience assessing business processes, identifying improvement opportunities, and developing practical solutions
Working knowledge of healthcare regulations, provider operations, medical claims processing, customer support practices, and business systems used to research, track, and resolve inquiries
Must reside in California
Reliable high-speed internet connectivity is required

Benefits

Comp & perks

Work flexibility
Learning and career development
Generous, flexible vacation policy
401(k) employer match
Comprehensive health benefits
Educational assistance
Leadership and technical development academies