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Claim Configuration Analyst Jobs in Florida (NOW HIRING)

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

$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 ...

ClinDCast

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 ...

ClinDCast LLC

Epic HB Analyst

Tampa, FL · On-site

$50 - $55/hr

... and configuration Support charge capture, billing workflows, claims, and remittance processes ... and claim rejections Collaborate with Epic PB, Cadence, Prelude, Resolute, and Clinical teams as ...

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Claim Configuration Analyst information

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 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 jobs make $3,000 a month without a degree?

A Claim Configuration Analyst can earn around $3,000 or more per month depending on experience and location, often without requiring a college degree. Other roles such as administrative assistants, sales representatives, or certain customer service positions may also reach this income level with relevant skills and experience. Many of these jobs focus on technical skills, certifications, or on-the-job training rather than formal degrees.

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 popular job titles related to Claim Configuration Analyst jobs in Florida? For Claim Configuration Analyst jobs in Florida, the most frequently searched job titles are:
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 May 2026, with employment types broken down into 100% Full Time. Highlights an 100% In-person job distribution.
Configuration Analyst

Configuration Analyst

Independent Living Systems LLC

Miami, FL • On-site

Other

This job post has expired today. Applications are no longer accepted.

Independent Living Systems rating

6.5

Company rating: 6.5 out of 10

Based on 8 frontline employees who took The Breakroom Quiz

Job description

Configuration Analyst

We are seeking a Configuration Analyst to join our team at Independent Living Systems (ILS). ILS, along with its affiliated health plans known as Florida Community Care and Florida Complete Care, is committed to promoting a higher quality of life and maximizing independence for all vulnerable populations.

The Configuration Analyst in the Health Care Services industry plays a critical role in ensuring that healthcare software systems and applications are accurately configured to meet organizational needs and regulatory requirements. This position involves analyzing system configurations, identifying areas for improvement, and implementing changes that enhance operational efficiency and data integrity. The analyst collaborates closely with clinical, administrative, and IT teams to tailor configurations that support member care workflows and compliance standards. By maintaining detailed documentation and performing rigorous testing, the Configuration Analyst ensures that system updates and new implementations function seamlessly within the healthcare environment. Ultimately, this role contributes to the delivery of high-quality healthcare services by optimizing the technological infrastructure that supports clinical and administrative processes.

Minimum Qualifications:

  • High School diploma or GED required
  • Minimum two (2) years' experience as a medical Senior Claim Examiner, Call Center Advocate, Business Analyst or Trainer
  • Medicare and Medicaid reimbursement methodologies including APR DRG / Exempt Units/ APG /RBRVS / APC.

Preferred Qualifications:

  • Associate's degree in health care or related fields
  • Knowledge of UB04 / CMS1500 claims, ICD-10 /Revenue/ CPT / HCPCS diagnosis and procedure coding, claim adjudication processes, EDI and OCR claim submission
  • Certification in Health IT or related fields (e.g., Certified Professional in Healthcare Information and Management Systems - CPHIMS).
  • Knowledge of data analytics and reporting tools used in healthcare settings.
  • Familiarity with project management methodologies and tools.
  • Experience in training and supporting end-users in healthcare technology environments.

Responsibilities:

  • Claims testing and processing including claim adjustments, as well as providing support and education to the staff as necessary.
  • The incumbent will troubleshoot and resolve provider records to support the claims operation.
  • Process claims in accordance with corporate policies and procedures and state regulations.
  • Review and analyze a variety of claim samples including auto-adjudicated claims to assure pricing per contractual agreement, negotiated rate or to Medicaid and Medicare rates.
  • Provide consistent feedback to Management in timely manner both individually and collectively.

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