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Claim Configuration Analyst Jobs in Georgia (NOW HIRING)

ProCare Rx

Client Support Specialist

Gainesville, GA · On-site

$16.75 - $22.50/hr

... and departmental claim and plan escalation requests. Assist with coordinating new group ... Provide backend support of plan design and benefit configuration to the Client Services team.

ProCare Rx

Client Support Specialist

Gainesville, GA · On-site

$16.75 - $22.50/hr

... and departmental claim and plan escalation requests. Assist with coordinating new group ... Provide backend support of plan design and benefit configuration to the Client Services team.

New

emergemarket.com

Director, Revenue Cycle

Marietta, GA · On-site

$140 - $190/hr

DSO, AR aging beyond 90 days, clean-claim rate, denial rate, and cash collections against ... Partner with the CFO and FP&A on cash forecasting, reserve methodology, and monthly reporting ...

QTS Realty Trust

Solution Architect

Suwanee, GA · On-site

$120 - $150/hr

Implementation & IntegrationOversee the technical implementation, configuration, and customization ... Strong communication, collaboration, and analytical skills, with a proactive, can-do attitude.

QTS Realty Trust, Inc.

Solution Architect

Suwanee, GA · On-site

$58.75 - $77.25/hr

Implementation & Integration * Oversee the technical implementation, configuration, and ... Strong communication, collaboration, and analytical skills, with a proactive, can-do attitude.

Zelis

Senior Solution Advisor, Payment Integrity

Atlanta, GA · Remote

$131K - $131K/yr

... its design, configuration, implementation, and utilization. Partner with Sales team to identify ... analysis to ensure metrics/reports accurately represent the product. Responsible for client ...

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Showing results 21-38

All JobsClaim Configuration Analyst JobsClaim Configuration Analyst Jobs in Georgia

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.
What are popular job titles related to Claim Configuration Analyst jobs in Georgia? For Claim Configuration Analyst jobs in Georgia, the most frequently searched job titles are:
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Claim Configuration Analyst jobs near you

Solution Architect

Quality Technology Services, LLC

Suwanee, GA • On-site

$58.75 - $77.25/hr

Full-time

Re-posted 22 days ago

Job description

As the Solution Architect, you will be responsible for designing, implementing, and governing robust, scalable cloud solutions that align with business objectives. You will serve as a trusted advisor, connecting business strategy with technical execution while maintaining the integrity of the application ecosystem. This role involves collaborating with stakeholders to define strategies, and offers the opportunity to drive digital transformation initiatives and mentor future leaders within the ecosystem.

The Solution Architect enhances project delivery by ensuring that both logical and physical architectures align with enterprise standards. Leveraging your knowledge of current technologies, reference architectures, and your implementation experience, you'll transform business needs into actionable solution blueprints that drive organizational success.


RESPONSIBILITIES, other duties may be assigned.

  • Solution Design

    • Design scalable, maintainable, and high-performing solutions that align with enterprise standards.

    • Assess existing business processes and translate them into effective technical specifications and architecture diagrams.

    • Ensure solution design supports global process harmonization, scalability, and compliance

    • Collaborate with stakeholders and technical teams to define solution roadmaps and create prototypes or proofs of concept.

  • Implementation & Integration

    • Oversee the technical implementation, configuration, and customization of application solutions and integrations.

    • Direct integration efforts using middleware tools and ensure seamless interoperability with other business systems.

    • Validate solutions through testing, performance tuning, and troubleshooting complex technical issues.

  • Governance & Best Practices

    • Ensure adherence to security, data governance, and change management policies.

    • Promote best practices and mentor team on architecture principles.

    • Stay current with system releases and upgrades to recommend relevant enhancements.

    • Establish KPIs and metrics to track performance

  • Innovation & Continuous Improvement

    • Stay current with emerging cloud technologies and recommend adoption where beneficial.

    • Establish KPIs and metrics to track performance

    • Drive automation and DevOps practices for efficient cloud operations.

BASIC QUALIFICATIONS

  • 8+ years of required cloud platform experience, including at least 4 years of proven experience in an architect role.
  • Strong background in security and data governance best practices and methodologies.
  • Proven experience mentoring or leading technical teams with measurable growth outcomes.
  • Strong communication, collaboration, and analytical skills, with a proactive, can-do attitude.

PREFERRED

  • Solution Architect certifications.
  • Exceptional stakeholder management and negotiation skills, with ability to engage C-level executives.
  • Familiarity with Agile methodologies and project management tools.

We conform to all the laws, statutes, and regulations concerning equal employment opportunities and affirmative action. We strongly encourage women, minorities, individuals with disabilities and veterans to apply to all of our job openings. We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, gender identity, or national origin, age, disability status, Genetic Information & Testing, Family & Medical Leave, protected veteran status, or any other characteristic protected by law. We prohibit retaliation against individuals who bring forth any complaint, orally or in writing, to the employer or the government, or against any individuals who assist or participate in the investigation of any complaint or discrimination claim.

The "Know Your Rights" Poster is included here:

Know Your Rights (English)

Know Your Rights (Spanish)

The pay transparency policy is available here:

Pay Transparency Nondiscrimination Poster-Formatted

QTS is committed to working with and providing reasonable accommodations to individuals with disabilities. If you need a reasonable accommodation because of a disability for any part of the employment process, please send an e-mail to talentacquisition@qtsdatacenters.com and let us know the nature of your request and your contact information.

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