ZipRecruiter

Log In

1

Claim Configuration Analyst Jobs in Connecticut (NOW HIRING)

Subway

Sr. IAM Engineer

Shelton, CT · On-site

$119K - $149K/yr

SSO application setup, IAM incident resolution and root-cause analysis, upgrades, patching, MFA ... configuration baselines; author technical design documents for significant automations and ...

Subway

Sr. IAM Engineer

Shelton, CT · Hybrid

$104K - $143K/yr

SSO application setup, IAM incident resolution and root-cause analysis, upgrades, patching, MFA ... configuration baselines; author technical design documents for significant automations and ...

All JobsClaim Configuration Analyst JobsClaim Configuration Analyst Jobs in Connecticut

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 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.

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.

Is claims processing a stressful job?

Claims processing as a Claim Configuration Analyst can be stressful due to tight deadlines, high accuracy requirements, and the need to resolve complex issues efficiently. The role often involves detailed data analysis and communication with stakeholders, which can contribute to work-related stress. 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 Connecticut?

For Claim Configuration Analyst jobs in Connecticut, the most frequently searched job titles are:

What job categories do people searching Claim Configuration Analyst jobs in Connecticut look for?

The top searched job categories for Claim Configuration Analyst jobs in Connecticut are:

What cities in Connecticut are hiring for Claim Configuration Analyst jobs?

Cities in Connecticut with the most Claim Configuration Analyst job openings:

Claim Configuration Analyst jobs near you

Revenue Cycle Analyst

ClientServer Technology Solutions LLC

Hartford, CT • On-site

Other

Posted 21 days ago

Job description

Role: Revenue Cycle AnalystExperience:10+ Years. Location: CT, MA(Onsite).Duration: Long Term-Contract. Position Overview

We are seeking a non-clinical analyst within the Clinical Informatics Department to support revenue cycle operations through data analysis, reporting, and revenue cycle system support. This role will work closely with revenue cycle leadership, finance, and information technology personnel to analyze operational and financial data, develop reports, and identify opportunities to improve billing accuracy, reimbursement, and revenue cycle performance.

The Revenue Cycle Analyst contributes a financial and reporting lens to clinical informatics initiatives, including EHR implementation, optimization, and system governance. This position does not involve direct patient care or clinical decision-making responsibilities.

Within the Clinical Informatics Department, the Revenue Cycle Analyst supports the effective use of clinical and financial data to drive operational and financial performance. The role focuses on bridging clinical documentation and revenue cycle outcomes by leveraging informatics tools, reporting, and data analysis.

The analyst collaborates with clinical informatics staff to:

●      Align revenue cycle reporting needs with EHR design and optimization efforts.

●      Support data governance, data definitions, and reporting standards across clinical and financial domains.

●      Identify opportunities where informatics-driven improvements can enhance billing accuracy, reimbursement, and revenue integrity.

This role strengthens the Clinical Informatics Department''s ability to deliver integrated clinical and financial insights that support organizational sustainability. This role will support the design, build, and configuration of revenue cycle-related components within the EHR.

Key Responsibilities Include

●      Develop and maintain operational and financial reports related to revenue cycle performance, including billing activity, claims submission, reimbursements, denials, and collections.

●      Analyze revenue cycle data to identify trends, operational inefficiencies, and propose opportunities to improve billing accuracy, reimbursement, and financial performance.

●      Support revenue cycle reporting and financial reconciliation activities during EHR system implementation, including participation in revenue cycle-related system build, configuration, and validation, and post-implementation optimization.

●      Collaborate with clinical informatics, revenue cycle leadership, finance staff, and information technology personnel to define reporting requirements and revenue cycle-related system build needs, and develop dashboards or reporting tools to support operational decision-making.

●      Support system testing, upgrades, and implementation activities related to revenue cycle systems and reporting tools, including participation in integrated testing, workflow validation, and issue resolution for revenue cycle-related EHR functionality.

●      Participate in the build, configuration, and maintenance of revenue cycle-related EHR components (e.g., billing workflows, charge capture support, revenue cycle reporting objects), under Clinical Informatics governance and change management processes.

●      Document reporting processes, data definitions, and maintain compliance with state and federal reporting requirements.

●      Monitor and report on core revenue cycle KPIs (e.g., net collection rate, clean claim rate, days in A/R, denial rate, cost to collect, discharged-not-final-billed) and flag adverse trends to leadership.

●      Support accounts receivable (A/R) follow-up by analyzing aging buckets and identifying aged or high-risk accounts requiring escalation.

●      Participate in denial management and appeals workflows, performing root-cause analysis on denial trends and coordinating corrective action with coding, clinical, and payer-facing staff.

●      Review charge capture processes and the Charge Description Master (CDM) to help ensure charges are complete, accurate, and compliant.

Analyze payer contract terms and fee schedules to validate expected reimbursement and identify underpayment or variance trends.

●      Support patient financial services functions, including self-pay/patient-balance reporting, statement accuracy, and compliance with price transparency requirements (e.g., the No Surprises Act and hospital price transparency rule).

●      Assist with responses to internal and external audits (e.g., payer

Apply