... resolve claim denial issues. * Coordinate configuration updates in Epic related to denial ... Proficient in UB-04 billing, denial trends analysis, and Epic configuration updates * Confident ...
... resolve claim denial issues. * Coordinate configuration updates in Epic related to denial ... Proficient in UB-04 billing, denial trends analysis, and Epic configuration updates * Confident ...
Analyze specific payer denials and recommend resolution. * Communicate with the insurance follow-up ... resolve claim denial issues. * Coordinate configuration updates in Epic related to denial ...
Analyze specific payer denials and recommend resolution. * Communicate with the insurance follow-up ... resolve claim denial issues. * Coordinate configuration updates in Epic related to denial ...
Systems Administrator
Huntsville, AL · On-site
Medical
Dental
Vision
Life
Retirement
PTO
The ideal candidate is a flexible, driven, diligent worker that can analyze the environment both as ... Actively claim, triage, and resolve IT tickets and contribute to the teams overall SLA matrixes.
Quick apply
Systems Administrator
Huntsville, AL · On-site
Medical
Dental
Vision
Life
Retirement
PTO
The ideal candidate is a flexible, driven, diligent worker that can analyze the environment both as ... Actively claim, triage, and resolve IT tickets and contribute to the teams overall SLA matrixes.
Claim Configuration Analyst information
What is a claim configuration analyst?
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?
| Aspect | Claim Configuration Analyst | Claims Processor |
|---|---|---|
| Primary Responsibilities | Designs and manages claim system setups, analyzes configuration issues, and optimizes claim workflows. | Processes individual claims, verifies information, and ensures accurate claim adjudication. |
| Required Skills & Certifications | Knowledge of insurance systems, data analysis, and possibly certifications like CPCU or similar. | Attention to detail, familiarity with claims software, and basic insurance knowledge. |
| Work Environment | Typically 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 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 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.
Is claims processing a stressful job?
Claims processing as a Claim Configuration Analyst can be stressful due to the need for accuracy, attention to detail, and meeting deadlines. The role often involves handling complex cases and using specialized software, which can contribute to work pressure. However, workload and stress levels vary depending on the organization and individual workload management skills.
What are popular job titles related to Claim Configuration Analyst jobs in Alabama?
For Claim Configuration Analyst jobs in Alabama, the most frequently searched job titles are:
What job categories do people searching Claim Configuration Analyst jobs in Alabama look for?
The top searched job categories for Claim Configuration Analyst jobs in Alabama are:
What cities in Alabama are hiring for Claim Configuration Analyst jobs?
Cities in Alabama with the most Claim Configuration Analyst job openings:
Full-time
Re-posted 28 days ago
Job description
Join a Respected Birmingham Team. Drive Denial Resolution. Make a Local Impact.
Westerkamp Group, LLC is a Birmingham-based Revenue Cycle Management (RCM) company helping hospitals across Alabama and the Southeast improve cash flow, reduce denials, and ensure accurate reimbursement. We are a trusted name in healthcare administration, built on a legacy of precision, transparency, and partnership.
We're currently hiring a Senior Denials Management Analyst to support a fast-growing hospital billing project. This on-site role is based at our Birmingham office at 200 Century Park South, with free parking and flexible scheduling options to help you commute outside of peak traffic times. It's an opportunity to make a meaningful difference in hospital financial health - and to grow your career in a stable and respected local organization.
Key Responsibilities
Qualifications
What We Offer
Our Recruitment Process
Qualified candidates will receive an email invitation to complete a brief video interview. We value your time and aim to make the process smooth and flexible based on your availability. If you are unable to complete the video interview, please contact us to request alternative interview options.
Equal Opportunity & Accommodations
Westerkamp Group, LLC, is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, religion, gender, national origin, disability, age, veteran status, or any other legally protected status.
If you need a reasonable accommodation during any stage of the application or interview process, please contact dbourgeois@wgrcm.com or call 985-655-0300.
Westerkamp Group, LLC is a Birmingham-based Revenue Cycle Management (RCM) company helping hospitals across Alabama and the Southeast improve cash flow, reduce denials, and ensure accurate reimbursement. We are a trusted name in healthcare administration, built on a legacy of precision, transparency, and partnership.
We're currently hiring a Senior Denials Management Analyst to support a fast-growing hospital billing project. This on-site role is based at our Birmingham office at 200 Century Park South, with free parking and flexible scheduling options to help you commute outside of peak traffic times. It's an opportunity to make a meaningful difference in hospital financial health - and to grow your career in a stable and respected local organization.
Key Responsibilities
- Coordinate the Denial Management activities for Hospital Based denials from various government and third-party payers.
- Provide reporting support for standard monthly denial reporting and ad-hoc denial report requests.
- Develop a monthly Denial Management MOR report and present it in person to senior management (company and client) during the monthly client meeting.
- Analyze specific payer denials and recommend resolution.
- Communicate with the insurance follow-up team and the appeals team to recommend actions for specific denials.
- Contact insurance payers when appropriate to identify the true nature of the denials
- Identify underpayments on large balance claims and validate the correct reimbursement model that was used for payment.
- A broad understanding of complex revenue cycle management concepts and theories including reimbursement models (MS-DRG, APR-DRG, EAPGs, carveouts, fee schedule hierarchies), CMS Local Coverage Determinations and National Coverage Determinations, Medical Policies, General Medical Coding concepts, extensive understanding of UB-04 claim concepts, among others.
- Escalate complex denial issues to senior management with recommendations for further actions to resolve claim denial issues.
- Coordinate configuration updates in Epic related to denial classification and source/owning departments.
- Monitor payer denials for trends and new denial issues caused by changes in their authorization/pre-cert/notification/referral requirements.
Qualifications
- 8-10 years of experience in hospital denial management or revenue cycle operations
- Bachelor's degree required
- Strong working knowledge of reimbursement models (MS-DRG, APR-DRG, EAPGs, fee schedules) and payer medical policy (LCD/NCD)
- Proficient in UB-04 billing, denial trends analysis, and Epic configuration updates
- Confident communicator with experience presenting data to senior leadership
- Proven ability to work independently, solve complex problems, and lead data-driven decisions
What We Offer
- Competitive salary based on experience
- Performance-based bonus potential
- A professional, mission-driven team in our Birmingham office.
- Free on-site parking and flexible start times to help you avoid peak traffic
- Career growth within a respected, stable healthcare company
Our Recruitment Process
Qualified candidates will receive an email invitation to complete a brief video interview. We value your time and aim to make the process smooth and flexible based on your availability. If you are unable to complete the video interview, please contact us to request alternative interview options.
Equal Opportunity & Accommodations
Westerkamp Group, LLC, is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, religion, gender, national origin, disability, age, veteran status, or any other legally protected status.
If you need a reasonable accommodation during any stage of the application or interview process, please contact dbourgeois@wgrcm.com or call 985-655-0300.
About Westerkamp Group
Sourced by ZipRecruiter
Company size
201 - 500 Employees
Headquarters location
Oak Brook, IL, US
Year founded
2009