ZipRecruiter

Log In

1

Claim Configuration Analyst Jobs in Colorado (NOW HIRING)

Capital Rx

Prior Authorization Systems Technician

Denver, CO · On-site

$18 - $21.75/hr

Monitor and triage system or configuration issues, escalating appropriately and partnering with ... basic analysis (e.g., validation, comparisons, tracking updates) * Experience working cross ...

Judi Health

Account Coordinator, PBA

Denver, CO · Hybrid

$20.50 - $26.75/hr

Analyze incoming client requests and work with internal and external teams to complete required ... Lead claim reviews to proactively identify discrepancies or inaccuracies and develop solutions to ...

Judi Health

Account Coordinator, PBA

Denver, CO · Hybrid

$20.50 - $26.75/hr

Analyze incoming client requests and work with internal and external teams to complete required ... Participate in claim reviews to proactively identify discrepancies or inaccuracies and develop ...

Capital Rx

Prior Authorization Systems Pharmacist

Denver, CO · On-site

$60 - $72/hr

... all claim administration-related workflows in one scalable, secure platform. Together with our ... Responsible for the design, configuration, and quality assurance of prior authorization (PA ...

next page

Showing results 1-20

All JobsClaim Configuration Analyst JobsClaim Configuration Analyst Jobs in Colorado

Claim Configuration Analyst information

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 often use specialized software or tools to optimize claim workflows. Strong attention to detail and knowledge of insurance or healthcare systems are essential for this role.

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 determine their validity and appropriate payout. They analyze claim details, ensure compliance with policies, and use data management tools to identify discrepancies or fraud, supporting accurate and efficient claims resolution.

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 leadership or highly specialized fields.

Is SOC an entry level job?

A SOC (Security Operations Center) analyst role is typically considered an entry to mid-level position, depending on the organization. Entry-level SOC analysts usually require basic knowledge of cybersecurity concepts, monitoring tools, and incident response, with opportunities for certification such as CompTIA Security+ to advance. Experience requirements vary, but many organizations offer training for new analysts.
What are popular job titles related to Claim Configuration Analyst jobs in Colorado? For Claim Configuration Analyst jobs in Colorado, the most frequently searched job titles are:
What job categories do people searching Claim Configuration Analyst jobs in Colorado look for? The top searched job categories for Claim Configuration Analyst jobs in Colorado are:
What cities in Colorado are hiring for Claim Configuration Analyst jobs? Cities in Colorado with the most Claim Configuration Analyst job openings:
Claim Configuration Analyst jobs near you
QA Analyst with Facets Claims experience

QA Analyst with Facets Claims experience

Cognizant Technology Solutions

Englewood, CO • On-site

$53K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 18 days ago

Cognizant rating

7.4

Company rating: 7.4 out of 10

Based on 85 frontline employees who took The Breakroom Quiz

52nd of 73 rated business consultants

Job description

About the role
As a QA Analyst with Facets Claims experience, you will make an impact by ensuring the quality, accuracy, and performance of healthcare payer claims processing applications. You will be a valued member of the Quality Engineering team and work collaboratively with business stakeholders, Facets configuration teams, developers, and testing teams to support large-scale healthcare transformation and Facets migration initiatives.
In this role, you will:
  • Perform end-to-end testing of Facets Claims processing applications to ensure business and system requirements are met.
  • Execute large-scale parallel testing activities, validating claim adjudication results between legacy platforms and Facets.
  • Validate Medicare claims processing workflows, configurations, and business rules within the Facets platform.
  • Conduct backend testing and data validation using SQL, claims data analysis, and database queries.
  • Design, develop, and execute functional, integration, regression, and system test cases and test scenarios.
  • Analyze high-volume claims processing results and identify defects, inconsistencies, and data issues.
  • Support defect triage, root cause analysis, retesting, and validation of production-ready solutions.
  • Collaborate closely with business users, Facets configuration teams, and development teams to ensure successful delivery of testing objectives.

Work model
We strive to provide flexibility wherever possible. Based on this role's business requirements, this is a remote position open to qualified applicants in the United States. Regardless of your working arrangement, we are here to support a healthy work-life balance through our various wellbeing programs.
The working arrangements for this role are accurate as of the date of posting. This may change based on the project you're engaged in, as well as business and client requirements. Rest assured; we will always be clear about role expectations
What you need to have to be considered
  • Strong hands-on experience in Facets Claims testing.
  • Deep understanding of healthcare payer claims adjudication processes and claims lifecycle management.
  • Experience performing both front-end and backend validation within Facets Claims applications.
  • Strong SQL skills with proven experience performing database and data validation testing.
  • Experience testing Medicare Claims processing workflows and business rules.
  • Ability to work independently in a hands-on testing environment with minimal supervision.
  • Experience supporting large-scale Facets migration or healthcare transformation programs.
  • Strong analytical, troubleshooting, and defect management skills.

These will help you stand out
  • Knowledge of 837 and 835 EDI transactions.
  • Experience supporting Federal healthcare programs, including CMS and Medicare initiatives.
  • Exposure to test automation frameworks and methodologies.
  • Experience with healthcare data migration testing and data reconciliation activities.
  • Familiarity with Agile delivery methodologies and healthcare regulatory requirements.

We're excited to meet people who share our mission and can make an impact in a variety of ways. Don't hesitate to apply, even if you only meet the minimum requirements listed. Think about your transferable experiences and unique skills that make you stand out as someone who can bring new and exciting things to this role.
Salary and Other Compensation:
The annual salary for this position is between $53,477 to 92,500 depending on experience and other qualifications of the successful candidate.
This position is also eligible for Cognizant's discretionary annual incentive program, based on performance and subject to the terms of Cognizant's applicable plans.
Benefits: Cognizant offers the following benefits for this position, subject to applicable eligibility requirements:
Medical/Dental/Vision/Life Insurance
Paid holidays plus Paid Time Off
401(k) plan and contributions
Long-term/Short-term Disability
Paid Parental Leave
Employee Stock Purchase Plan
Disclaimer: The salary, other compensation, and benefits information is accurate as of the date of this posting. Cognizant reserves the right to modify this information at any time, subject to applicable law.
Cognizant will only consider applicants for this position who are legally authorized to work in the United States without company sponsorship.
*Please note, this role is not able to offer visa transfer or sponsorship now or in the future*
About Cognizant:
Cognizant (Nasdaq: CTSH) is an AI Builder and technology services provider, bridging the gap between AI investment and enterprise value by building full-stack AI solutions for our clients. Our deep industry, process and engineering expertise enables us to build an organization's unique context into technology systems that amplify human potential, drive tangible outcomes and keep global enterprises ahead in a fast-changing world. See how at cognizant.ai or @cognizant.
Additional employment information
Compensation information is accurate as of the date of this posting. Cognizant reserves the right to modify this information at any time, subject to applicable law.
Applicants may be required to attend interviews in person or by video conference. In addition, candidates may be required to present their current state or government issued ID during each interview.
Cognizant is an equal opportunity employer. Your application and candidacy will not be considered based on race, color, sex, religion, creed, sexual orientation, gender identity, national origin, disability, genetic information, pregnancy, veteran status or any other characteristic protected by federal, state or local laws.
If you have a disability that requires reasonable accommodation to search for a job opening or submit an application, please email [email protected] for roles based in the Americas or [email protected] for roles based in India.

What Cognizant employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

Apply