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Claim Configuration Analyst Jobs (NOW HIRING)

CGI Inc.

Configuration Analyst

Canton, MA · On-site

Configuration Analyst Category: Business Analysis (functional and technical) Main location: United ... Validate claim adjudication outcomes against expected benefit logic including repricing, edits, and ...

Versant Health

Configuration Analyst

Troy, NY · On-site

$60K - $65K/yr

Configuration Analyst Who are we? Versant Health is one of the nation's leading administrators of ... Configure and maintain the claim processing system mapping and all interface modules * Analyze ...

Vytwo

Facets Configuration Analyst

Prosper, TX · Remote

... Claim Processing, Billing, Plan/Product, At least 3 years experience building contracts in NetworX Strong knowledge on FACETS Architecture which includes Upstream and Downstream systems Requires ...

ClinDCast LLC

Facets Configuration Analyst

Albany, NY · Remote

... Claim Processing, Billing, Plan/Product, At least 3 years experience building contracts in NetworX Strong knowledge on FACETS Architecture which includes Upstream and Downstream systems Requires ...

Clover Health

Senior Strategic Configuration Analyst

$90K - $119K/yr

... claim payment accuracy. Your focus is the technical validation and rigorous testing of ... As a Senior Strategic Configuration Analyst, you will: * Testing Framework Design & Execution:

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Claim Configuration Analyst information

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How much do claim configuration analyst jobs pay per hour?

As of Jun 13, 2026, the average hourly pay for claim configuration analyst in the United States is $41.31, according to ZipRecruiter salary data. Most workers in this role earn between $30.53 and $52.88 per hour, depending on experience, location, and employer.

What are Claim Configuration Analysts?

Claim Configuration Analysts are professionals who specialize in setting up and maintaining the rules, processes, and systems that handle insurance claims within an organization. They ensure that claim processing systems are configured accurately to follow policy guidelines, regulatory requirements, and company procedures. Their role often involves analyzing data, troubleshooting issues, and collaborating with IT, claims, and business teams to optimize claim workflows. By ensuring correct system configurations, they help reduce errors, improve operational efficiency, and support timely claim resolutions.

What is the difference between Claim Configuration Analyst vs Claims Processor?

AspectClaim Configuration AnalystClaims Processor
Primary ResponsibilitiesDesigns and manages claim system setups, analyzes configuration issues, and optimizes claim workflows.Processes individual claims, verifies information, and ensures accurate claim adjudication.
Required Skills & CertificationsKnowledge of insurance systems, data analysis, and possibly certifications like CPCU or similar.Attention to detail, familiarity with claims software, and basic insurance knowledge.
Work EnvironmentTypically office-based, working with IT teams and claims systems.Office or remote, handling claims directly or via claims processing platforms.

The Claim Configuration Analyst focuses on configuring and optimizing claim systems and workflows, while the Claims Processor handles the day-to-day processing of individual claims. Both roles require insurance knowledge, but the analyst role emphasizes system setup and analysis, whereas the processor role emphasizes claim review and verification.

What does a configuration analyst do?

A claim configuration analyst is responsible for setting up and maintaining claim processing systems, ensuring accurate claim adjudication and compliance with policies. They analyze system configurations, troubleshoot issues, and may use tools like claim management software to optimize workflows and reduce errors.

What are the key skills and qualifications needed to thrive as a Claim Configuration Analyst, and why are they important?

To thrive as a Claim Configuration Analyst, you need a strong understanding of healthcare claims processing, benefits administration, and analytical problem-solving, often supported by a degree in business, information systems, or a related field. Familiarity with claims adjudication systems (such as Facets or QNXT), SQL, and potentially industry certifications like Certified Claims Professional (CCP) are commonly required. Attention to detail, effective communication, and the ability to work collaboratively with cross-functional teams are crucial soft skills. These competencies ensure accurate claim system configuration, regulatory compliance, and efficient operations within health insurance organizations.

What does a claims analyst do?

A claims analyst reviews and processes insurance claims to ensure accuracy and compliance with policies. They investigate claim details, verify documentation, and determine claim validity, often using specialized software and data analysis skills. Their work helps ensure timely and fair claim settlements for clients and insurers.

What are some common challenges faced by Claim Configuration Analysts, and how can they be addressed?

Claim Configuration Analysts often encounter challenges such as interpreting complex insurance policies, ensuring accurate system configuration to minimize claim errors, and keeping up with frequent regulatory changes. Addressing these challenges requires strong analytical skills, attention to detail, and effective collaboration with cross-functional teams like IT, compliance, and claims processing. Regular training and open communication channels help analysts stay updated and maintain high-quality configurations, ultimately reducing errors and improving efficiency.

What jobs pay 500,000 a year in the US?

Claim Configuration Analysts typically do not earn $500,000 annually; such high salaries are usually associated with executive roles, specialized surgeons, or successful entrepreneurs. High-paying jobs often require advanced skills, extensive experience, or ownership of a business. Compensation at this level is rare in standard analyst positions and more common in executive or highly specialized fields.

What jobs pay 2000 a day?

Claim Configuration Analysts typically do not earn $2000 a day; such high daily rates are more common in specialized consulting, executive roles, or highly paid freelance positions. Most standard roles in claims analysis offer annual salaries rather than daily rates, but freelance or contract work in related fields can sometimes reach that level with extensive experience and expertise. Earning $2000 a day generally requires advanced skills, certifications, or senior-level responsibilities in high-demand industries.
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Claim Configuration Analyst jobs near you
Configuration Analyst

Configuration Analyst

Independent Living Systems

Miami, FL • On-site

Full-time

Posted 29 days ago

Independent Living Systems rating

6.5

Company rating: 6.5 out of 10

Based on 8 frontline employees who took The Breakroom Quiz

Job description

We are seeking a Configuration Analyst to join our team at Independent Living Systems (ILS). ILS, along with its affiliated health plans known as Florida Community Care and Florida Complete Care, is committed to promoting a higher quality of life and maximizing independence for all vulnerable populations.

About the Role:

The Configuration Analyst in the Health Care Services industry plays a critical role in ensuring that healthcare software systems and applications are accurately configured to meet organizational needs and regulatory requirements. This position involves analyzing system configurations, identifying areas for improvement, and implementing changes that enhance operational efficiency and data integrity. The analyst collaborates closely with clinical, administrative, and IT teams to tailor configurations that support member care workflows and compliance standards. By maintaining detailed documentation and performing rigorous testing, the Configuration Analyst ensures that system updates and new implementations function seamlessly within the healthcare environment. Ultimately, this role contributes to the delivery of high-quality healthcare services by optimizing the technological infrastructure that supports clinical and administrative processes.

Minimum Qualifications:

  • High School diploma or GED required
  • Minimum two (2) years' experience as a medical Senior Claim Examiner, Call Center Advocate, Business Analyst or Trainer
  • Medicare and Medicaid reimbursement methodologies including APR DRG / Exempt Units/ APG /RBRVS / APC.

Preferred Qualifications:

  • Associate's degree in health care or related fields
  • Knowledge of UB04 / CMS1500 claims, ICD-10 /Revenue/ CPT / HCPCS diagnosis and procedure coding, claim adjudication processes, EDI and OCR claim submission
  • Certification in Health IT or related fields (e.g., Certified Professional in Healthcare Information and Management Systems - CPHIMS).
  • Knowledge of data analytics and reporting tools used in healthcare settings.
  • Familiarity with project management methodologies and tools.
  • Experience in training and supporting end-users in healthcare technology environments.

Responsibilities:

  • Claims testing and processing including claim adjustments, as well as providing support and education to the staff as necessary.
  • The incumbent will troubleshoot and resolve provider records to support the claims operation.
  • Process claims in accordance with corporate policies and procedures and state regulations.
  • Review and analyze a variety of claim samples including auto-adjudicated claims to assure pricing per contractual agreement, negotiated rate or to Medicaid and Medicare rates.
  • Provide consistent feedback to Management in timely manner both individually and collectively.