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Claim Configuration Analyst Jobs in Connecticut (NOW HIRING)

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 ...

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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?

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 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.
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MANAGEMENT ASSISTANT with Security Clearance

Department of the Navy

Groton, CT • On-site

$41K - $48K/yr

Other

Posted 4 days ago


United States Navy rating

6.4

Company rating: 6.4 out of 10

Based on 379 frontline employees who took The Breakroom Quiz

42nd of 49 rated military and defense


Job description

Duties * You will assist in the configuration management processes employed by all ship programs under SUPSHIP Groton's oversight. * You will be responsible for the identification, status, control, electronic documentation and distribution of engineering change documentation, departures and other configuration management documents. * You will assess database performance and accuracy, troubleshoot, resolve performance issues and restore database integrity when required. * You will review and coordinate drawing submittals, and approvals with Contractor representatives. * You will develop and maintain the Engineering Department Training Plan and the Engineering Comprehensive Technical Training Program. * You will maintain, administer, and coordinate the Engineering Department Central Log for Repair Availabilities and New Construction Key Events in support of configuration management. * You will assist in the development and maintenance of SUPSHIP Standard Operating Procedures and instructions necessary to properly administer configuration management processes. * You will research technical training programs and analyze local training requirements to develop a comprehensive Engineering Department Training Program which suits the needs of all experience levels. Requirements Conditions of employment * Must be a US Citizen. * Must be determined suitable for federal employment. * Must participate in the direct deposit pay program. * New employees to the Department of the Navy will be required to successfully pass the E-Verify employment verification check. To learn more about E-Verify, including your rights and responsibilities, visit e-verify.gov * Within the Department of Defense (DoD), the appointment of retired military members within 180 days immediately following retirement date to a civilian position is subject to the provisions of 5 United States Code 3326. * Males born after 12-31-59 must be registered for Selective Service. * You will be required to obtain and maintain an interim and/or final security clearance prior to entrance on duty. Failure to obtain and maintain the required level of clearance may result in the withdrawal of a job offer or removal. * This position may require travel from normal duty station to CONUS and OCONUS and may include remote or isolated sites. You must be able to travel on military and commercial aircraft for extended periods of time. Qualifications Your resume must demonstrate at least one year of specialized experience at or equivalent to the (GS-06) grade level or pay band in the Federal service or equivalent experience in the private or public sector. Specialized experience must demonstrate the following: Applying knowledge of management or program analysis guidelines to assist in the development, evaluation or improvement of an organization's work methods, procedures or configuration management processes. Additional qualification information can be found from the following Office of Personnel Management website: Experience refers to paid and unpaid experience, including volunteer work done through National Service programs (e.g., professional, philanthropic, religious, spiritual, community, student, social). Volunteer work helps build critical competencies, knowledge, and skills and can provide valuable training and experience that translates directly to paid employment. Education In lieu of specialized experience, you may qualify with the following education or combination of both education and experience: * One full year of graduate level education in a field of study directly related to the position; OR * A combination of experience and graduate education as described above that equates to one year of experience. A transcript must be submitted with your application if qualifying using education. See Required Documents for additional information. Additional information This announcement uses the Direct Hire Authority (DHA) for Domestic Defense Industrial Base Facilities & Major Range/Test Facilities Base in DoD (DIB/MRTFB) to recruit and appoint qualified candidates to positions in the competitive service. This position is covered by the Department of Defense Priority Placement Program. Several vacancies may be filled. A tentative offer of employment will be rescinded if the selectee fails to meet the pre-employment requirements, including failure to report to any of the scheduled appointments. Federal annuitant information: The selection of an annuitant is subject to the Department of Defense and Department of the Navy policy on the employment of annuitants. Policy information may be found at: . Veteran's preference does not apply when selecting individuals under this specific hiring authority. However, if you claim veteran's preference, you will be required to submit supporting documentation with your application as described in the Required Documents section below.

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National security, national security and international affairs, public safety statistics centers and offices, guided missile and space vehicle manufacturing and public administration

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Headquarters location

Washington, DC, US

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