... configuration, and/or integration, and will work closely with business and technical teams to ... business analysts and stakeholders to gather and analyze requirements - Develop and maintain ...
... configuration, and/or integration, and will work closely with business and technical teams to ... business analysts and stakeholders to gather and analyze requirements - Develop and maintain ...
Discovery Business and System Analyst (Top Secret Clearance Requ with Security Clearance
Los Angeles, CA · On-site
$92K - $125K/yr
... industry solution providers that claim to satisfy the identified business requirements ... configuration changes to insure that the Discovery Program maintains an accurate picture of its ...
Discovery Business and System Analyst (Top Secret Clearance Requ with Security Clearance
Los Angeles, CA · On-site
$92K - $125K/yr
... industry solution providers that claim to satisfy the identified business requirements ... configuration changes to insure that the Discovery Program maintains an accurate picture of its ...
Analyst III, Epic Application Professional Billing and Claims
Irvine, CA · On-site
$103K - $133K/yr
... configuration, testing, and support of the Epic Professional Billing and Claims modules ... This role ensures accurate and efficient billing workflows, claim generation, and revenue cycle ...
Analyst III, Epic Application Professional Billing and Claims
Irvine, CA · On-site
$103K - $133K/yr
... configuration, testing, and support of the Epic Professional Billing and Claims modules ... This role ensures accurate and efficient billing workflows, claim generation, and revenue cycle ...
Analyst III, Epic Application Professional Billing and Claims
Irvine, CA · On-site
$103K/yr
... configuration, testing, and support of the Epic Professional Billing and Claims modules ... This role ensures accurate and efficient billing workflows, claim generation, and revenue cycle ...
Analyst III, Epic Application Professional Billing and Claims
Irvine, CA · On-site
$103K/yr
... configuration, testing, and support of the Epic Professional Billing and Claims modules ... This role ensures accurate and efficient billing workflows, claim generation, and revenue cycle ...
Senior Discovery Business and System Analyst (Top Secret Clearance Required)
San Francisco, CA · On-site +1
$118K - $171K/yr
... industry solution providers that claim to satisfy the identified business requirements ... configuration changes to insure that the Discovery Program maintains an accurate picture of its ...
Senior Discovery Business and System Analyst (Top Secret Clearance Required)
San Francisco, CA · On-site +1
$118K - $171K/yr
... industry solution providers that claim to satisfy the identified business requirements ... configuration changes to insure that the Discovery Program maintains an accurate picture of its ...
Senior Discovery Business and System Analyst (Top Secret Clearance Required)
San Francisco, CA · On-site
$118K - $171K/yr
... industry solution providers that claim to satisfy the identified business requirements ... configuration changes to insure that the Discovery Program maintains an accurate picture of its ...
Quick apply
Senior Discovery Business and System Analyst (Top Secret Clearance Required)
San Francisco, CA · On-site
$118K - $171K/yr
... industry solution providers that claim to satisfy the identified business requirements ... configuration changes to insure that the Discovery Program maintains an accurate picture of its ...
... industry solution providers that claim to satisfy the identified business requirements ... configuration changes to insure that the Discovery Program maintains an accurate picture of its ...
Quick apply
... industry solution providers that claim to satisfy the identified business requirements ... configuration changes to insure that the Discovery Program maintains an accurate picture of its ...
Senior Discovery Business and System Analyst (Top Secret Clearance Required)
San Francisco, CA · On-site
$118K - $171K/yr
... industry solution providers that claim to satisfy the identified business requirements ... configuration changes to insure that the Discovery Program maintains an accurate picture of its ...
Senior Discovery Business and System Analyst (Top Secret Clearance Required)
San Francisco, CA · On-site
$118K - $171K/yr
... industry solution providers that claim to satisfy the identified business requirements ... configuration changes to insure that the Discovery Program maintains an accurate picture of its ...
Senior Discovery Business and System Analyst (Top Secret Clearance Required)
Los Angeles, CA · On-site
$118K - $171K/yr
... industry solution providers that claim to satisfy the identified business requirements ... configuration changes to insure that the Discovery Program maintains an accurate picture of its ...
Senior Discovery Business and System Analyst (Top Secret Clearance Required)
Los Angeles, CA · On-site
$118K - $171K/yr
... industry solution providers that claim to satisfy the identified business requirements ... configuration changes to insure that the Discovery Program maintains an accurate picture of its ...
Senior Discovery Business and System Analyst (Top Secret Clearan with Security Clearance
Los Angeles, CA · On-site
$118K - $171K/yr
... industry solution providers that claim to satisfy the identified business requirements ... configuration changes to insure that the Discovery Program maintains an accurate picture of its ...
Senior Discovery Business and System Analyst (Top Secret Clearan with Security Clearance
Los Angeles, CA · On-site
$118K - $171K/yr
... industry solution providers that claim to satisfy the identified business requirements ... configuration changes to insure that the Discovery Program maintains an accurate picture of its ...
Adjudicator, Provider Medical Claims (Inbound Calls)
Long Beach, CA · Remote
$15.58 - $31.97/hr
... configuration and claims processing teams to appropriately address provider claim issues. Responds ... Research and data analysis skills. Organizational skills and attention to detail. Time-management ...
Adjudicator, Provider Medical Claims (Inbound Calls)
Long Beach, CA · Remote
$15.58 - $31.97/hr
... configuration and claims processing teams to appropriately address provider claim issues. Responds ... Research and data analysis skills. Organizational skills and attention to detail. Time-management ...
Adjudicator, Provider Medical Claims (Inbound Calls)
Long Beach, CA · On-site +1
$15.58 - $31.97/hr
... configuration and claims processing teams to appropriately address provider claim issues. • ... analysis within a managed care organization, or equivalent combination of relevant education and ...
Adjudicator, Provider Medical Claims (Inbound Calls)
Long Beach, CA · On-site +1
$15.58 - $31.97/hr
... configuration and claims processing teams to appropriately address provider claim issues. • ... analysis within a managed care organization, or equivalent combination of relevant education and ...
Preferred knowledge of EDI 270/271 configuration, transaction rules and Claim Processing Rules (Procedure and Diagnosis Codes) * Preferred at least 5 years of experience in a configuration analyst ...
Preferred knowledge of EDI 270/271 configuration, transaction rules and Claim Processing Rules (Procedure and Diagnosis Codes) * Preferred at least 5 years of experience in a configuration analyst ...
Clinical Policy Clinical Coder RN II
$132K - $163K/yr
Investigate and resolve coding and authorization related issues, including claim denials, coding ... research analysis based on the best available evidence. Proficient in claims configuration ...
Clinical Policy Clinical Coder RN II
$132K - $163K/yr
Investigate and resolve coding and authorization related issues, including claim denials, coding ... research analysis based on the best available evidence. Proficient in claims configuration ...
Clinical Policy Clinical Coder RN II
Los Angeles, CA · On-site
$132K - $163K/yr
Investigate and resolve coding and authorization related issues, including claim denials, coding ... research analysis based on the best available evidence. Proficient in claims configuration ...
Clinical Policy Clinical Coder RN II
Los Angeles, CA · On-site
$132K - $163K/yr
Investigate and resolve coding and authorization related issues, including claim denials, coding ... research analysis based on the best available evidence. Proficient in claims configuration ...
Adjudicator, Provider Claims (Inbound Calls)
Long Beach, CA · Remote
$15.58 - $31.97/hr
... configuration and claims processing teams to appropriately address provider claim issues. Responds ... Research and data analysis skills. Organizational skills and attention to detail. Time-management ...
Adjudicator, Provider Claims (Inbound Calls)
Long Beach, CA · Remote
$15.58 - $31.97/hr
... configuration and claims processing teams to appropriately address provider claim issues. Responds ... Research and data analysis skills. Organizational skills and attention to detail. Time-management ...
Adjudicator, Provider Claims (Inbound Calls)
Long Beach, CA · On-site +1
$15.58 - $31.97/hr
... configuration and claims processing teams to appropriately address provider claim issues. • ... analysis within a managed care organization, or equivalent combination of relevant education and ...
Adjudicator, Provider Claims (Inbound Calls)
Long Beach, CA · On-site +1
$15.58 - $31.97/hr
... configuration and claims processing teams to appropriately address provider claim issues. • ... analysis within a managed care organization, or equivalent combination of relevant education and ...
BILLING SUPERVISOR II
Daly City, CA · On-site
$62K - $81K/yr
... the Epic Analyst (who owns system configuration) to report, validate, and resolve front-end ... claim and edit rates) for the Revenue Cycle Manager and Administration. * Performs additional ...
BILLING SUPERVISOR II
Daly City, CA · On-site
$62K - $81K/yr
... the Epic Analyst (who owns system configuration) to report, validate, and resolve front-end ... claim and edit rates) for the Revenue Cycle Manager and Administration. * Performs additional ...
CLAIMS EXAMINER I MSO
Burlingame, CA · On-site
$38/hr
Identify claims payment errors and/or system configuration flaws during day-to-day operation ... claim forms preferred. * Strong English communication skills with strong analytical and problem ...
CLAIMS EXAMINER I MSO
Burlingame, CA · On-site
$38/hr
Identify claims payment errors and/or system configuration flaws during day-to-day operation ... claim forms preferred. * Strong English communication skills with strong analytical and problem ...
CLAIMS EXAMINER I MSO
Burlingame, CA · On-site
$38/hr
Identify claims payment errors and/or system configuration flaws during day-to-day operation ... claim forms preferred. * Strong English communication skills with strong analytical and problem ...
CLAIMS EXAMINER I MSO
Burlingame, CA · On-site
$38/hr
Identify claims payment errors and/or system configuration flaws during day-to-day operation ... claim forms preferred. * Strong English communication skills with strong analytical and problem ...
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 California? For Claim Configuration Analyst jobs in California, the most frequently searched job titles are:
- Configuration Management Consultant
- Configuration Engineer
- Freelance Facets Configuration Analyst
- Remote Business Intelligence Reporting Analyst
- Configuration Management Analyst
- Remote Configuration Analyst
- Configuration Management Specialist
- Work From Home Facets Configuration Analyst
- Configuration Analyst
- Lims Analyst
What job categories do people searching Claim Configuration Analyst jobs in California look for? The top searched job categories for Claim Configuration Analyst jobs in California are:
What cities in California are hiring for Claim Configuration Analyst jobs? Cities in California with the most Claim Configuration Analyst job openings:
Contractor
Posted 15 days ago
Job description
Position: Guidewire ClaimCenter Developer
Location: California (Onsite)
Duration: 12 Months Contract
Job Description:
We are seeking an experienced Guidewire ClaimCenter professional for a 12-month contract opportunity in California. The ideal candidate will have hands-on expertise in Guidewire ClaimCenter implementation, configuration, and/or integration, and will work closely with business and technical teams to deliver solutions that enhance claims processing efficiency.
Responsibilities:
- Configure and customize Guidewire ClaimCenter modules based on business requirements
- Collaborate with business analysts and stakeholders to gather and analyze requirements
- Develop and maintain ClaimCenter integrations with internal and external applications (as needed)
- Write technical specifications and documentation
- Troubleshoot, test, and resolve ClaimCenter defects and issues
- Provide support during system upgrades and user acceptance testing (UAT)
- Ensure compliance with California insurance regulations and industry standards
Required Skills:
- 3+ years of hands-on experience with Guidewire ClaimCenter (configuration, integration, or development)
- Proficiency in Guidewire tools such as GOSU, Data Model, Product Model, Web Services
- Experience with Java, XML, SQL, and related technologies
- Strong understanding of property & casualty (P&C) insurance business processes
- Excellent problem-solving and communication skills
- Ability to work independently and as part of a team
Location: California (Onsite)
Duration: 12 Months Contract
Job Description:
We are seeking an experienced Guidewire ClaimCenter professional for a 12-month contract opportunity in California. The ideal candidate will have hands-on expertise in Guidewire ClaimCenter implementation, configuration, and/or integration, and will work closely with business and technical teams to deliver solutions that enhance claims processing efficiency.
Responsibilities:
- Configure and customize Guidewire ClaimCenter modules based on business requirements
- Collaborate with business analysts and stakeholders to gather and analyze requirements
- Develop and maintain ClaimCenter integrations with internal and external applications (as needed)
- Write technical specifications and documentation
- Troubleshoot, test, and resolve ClaimCenter defects and issues
- Provide support during system upgrades and user acceptance testing (UAT)
- Ensure compliance with California insurance regulations and industry standards
Required Skills:
- 3+ years of hands-on experience with Guidewire ClaimCenter (configuration, integration, or development)
- Proficiency in Guidewire tools such as GOSU, Data Model, Product Model, Web Services
- Experience with Java, XML, SQL, and related technologies
- Strong understanding of property & casualty (P&C) insurance business processes
- Excellent problem-solving and communication skills
- Ability to work independently and as part of a team
About Lorven technologies
Sourced by ZipRecruiter
Lorven Technologies, headquartered in Plainsboro, New Jersey, United States, is a reputable company in the technology industry, specializing in providing effective IT solutions and consulting services. The company's official website, lorventech.com, offers comprehensive insights into its offerings which include but are not limited to software development, IT consulting, project management, and business analysis. Since its inception, Lorven Technologies has been committed to ensuring efficiency and reliability in delivering IT services to its global clientele, establishing itself as a trusted name in the industry.
Industry
It services
Company size
51 - 200 Employees
Headquarters location
Plainsboro, NJ, US
Year founded
2001