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Claim Configuration Analyst Jobs in Florida (NOW HIRING)

ClinDCast LLC

Epic HB Claims Analyst

Tampa, FL · On-site

$60 - $65/hr

... configuration, workflow optimization, claims management, and revenue integrity initiatives. This ... Configure and maintain claim edits, workqueues, billing rules, and charge routing processes.

Solis Health Plans

Claim Examiner I

Miami, FL · On-site

$19 - $23/hr

Review, analyze, and process medical claims in accordance with Medicare and DSNP benefit structures ... Configuration teams to resolve claim issues. * Participate in audits, quality reviews, and ...

ClinDCast LLC

Epic HB Analyst

Delray Beach, FL · On-site

$50 - $55/hr

Translate operational workflows into Epic system build and configuration * Support charge capture ... Troubleshoot billing errors, charge issues, and claim rejections * Collaborate with Epic PB ...

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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.
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What job categories do people searching Claim Configuration Analyst jobs in Florida look for? The top searched job categories for Claim Configuration Analyst jobs in Florida are:
What cities in Florida are hiring for Claim Configuration Analyst jobs? Cities in Florida with the most Claim Configuration Analyst job openings:
Claim Configuration Analyst jobs near you
Infographic showing various Claim Configuration Analyst job openings in Florida as of July 2026, with employment types broken down into 100% Full Time. Highlights an 100% In-person job distribution.

Configuration Analyst

Avalon Administrative Services LLC

Tampa, FL • On-site

Full-time

Posted 9 days ago

Job description

About Avalon Healthcare Solutions:

Avalon Healthcare Solutions is the nation’s leader in diagnostic intelligence, uniquely focused on transforming the role of diagnostic testing across the healthcare ecosystem. Our proprietary Diagnostic Insights Platform delivers evidence-based policies, curated lab networks, and real-time analytics that simplify complex diagnostics, accelerate innovation adoption, and optimize diagnostic investments.

Supporting over 30 health plans and 100 million members nationwide, Avalon partners with payers and providers to ensure diagnostic testing is performed appropriately, efficiently, and at the right time. Our flexible solutions span routine and genetic testing management, automated adherence, and end-to-end diagnostics support—driving measurable value, reduced waste, and improved clinical outcomes.

With unmatched scientific rigor, deep clinical expertise, and a performance-based model, Avalon is redefining how diagnostics power personalized care and healthcare value.
Learn more at www.avalonhcs.com.

You will be part of a team that shapes a new market and business. Most importantly, you will help Avalon to achieve its mission and improve clinical outcomes and health care affordability for the people we serve.

For more information about Avalon, please visit www.avalonhcs.com.

Avalon Healthcare Solutions is an Equal Opportunity Employer - Vet/Disability.

This position description is subject to change at any time. As determined by the company based upon business needs, an employee in this position may be required to perform duties and take responsibility for work other than as described in this document.

About the Configuration Analyst Position:

Reporting to the Manager, Configuration, the Configuration Analyst is responsible for updating managed care claims processing, maintenance and support of interfaces and third-party applications, process flow updates and enhancements.

This position is eligible for remote work, but quarterly travel will be required to Avalon's corporate office located in Tampa, Florida.

Configuration Analyst – Essential Functions and Responsibilities:

  • Perform analyses of Avalon laboratory benefits management configuration in order to determine and create use cases for regression testing.
  • Ability to take requirements from medical policy translation documents and successfully incorporate these as rules in the Avalon laboratory benefits management configuration file.
  • Run regression testing prior to Production releases for Avalon Claim Editor to ensure optimal functionality of the Claim Editor.
  • Development and maintenance of ReadyAPI! test suite for regression testing management.
  • Validate and/or provide input to LBM global rules process flows.

Configuration Analyst – Minimum Qualifications:

  • 3+ years of relevant work experience
  • Bachelor’s degree in Business or similar field or equivalent work experience
  • At least 3 years of experience developing and managing business requirements throughout a project lifecycle.
  • Experience in or knowledge of the health care business and customer service.
  • Intermediate knowledge of Microsoft Excel and Access.
  • Experience with use case testing.
  • 1 - 2 years’ experience in reporting, with a preference for intermediate knowledge of SQL
  • Knowledge of one or more of the following areas of health plan operations - configuration, utilization, claims processing, and/or reimbursement.
  • Proven analytical and project management skills, including a thorough understanding of how to interpret customer business needs and translate them into application and operational requirements.
  • Facilitation skills that include workgroup leadership, problem resolution across multiple groups, etc.
  • Willingness to work in various capacities and to learn new skill sets.

Apply