Senior Healthcare QA Representative - Remote US

Summary

Gainwell Technologies is seeking an experienced Sr. Healthcare Quality Assurance professional to support quality assurance, auditing, and financial operations within a healthcare environment. This role combines healthcare knowledge, financial and operational auditing, data analysis, and hands-on SQL experience to evaluate processes, identify discrepancies, ensure compliance, and support continuous improvement.

The ideal candidate brings strong analytical skills, healthcare industry experience, knowledge of medical terminology, and the ability to independently research and resolve complex operational and financial issues. 

Your role in our mission

• Perform quality assurance and audit activities across healthcare financial operations, including accounts receivable/payable, capitation, credit balances, cost settlements, recoveries, and related processes.
• Review financial transactions, healthcare data, reports, and supporting documentation to identify discrepancies and ensure accuracy and compliance with established controls.
• Use SQL to query, extract, review, and analyze data in support of audits, reporting, research, reconciliation, and operational analysis.
• Create, maintain, and update audit procedures, control documentation, operational processes, and client-required reporting.
• Research complex financial and operational issues, recommend process improvements, and serve as a resource to team members on quality, audit, and operational requirements.

What we're looking for

• Bachelor’s degree or equivalent combination of education and relevant professional experience in quality assurance, auditing, finance, accounting, financial analysis, or a related function.
• Healthcare industry experience, preferably within Medicaid, Medicare, managed care, health insurance, claims, or government healthcare programs.
• One to two years of hands-on SQL experience, including querying, extracting, reviewing, and analyzing data.
• Working knowledge of medical terminology with experience interpreting healthcare-related data, claims, documentation, and operational information.
• Knowledge of financial controls and accounting principles, including GAAP and/or SOX, with strong analytical, research, problem-solving, and communication skills.

What you should expect in this role

• This position is remote work from home, candidate must reside in the United States. 
• Comprehensive benefits for eligible employees, including medical, dental, and vision coverage.
• Access to a 401(k) retirement savings plan and additional employee wellness and financial benefits.
• Paid time off and paid holidays to support work-life balance.
• Opportunities for professional development and career growth within Gainwell Technologies.

Applications for this position will be accepted through October 31, 2026.

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