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Claim Configuration Analyst Jobs in Missouri (NOW HIRING)

Advantage Tech

Claims Specialist

Kansas City, MO · On-site

... configuration, benefit interpretation, documentation, vendor execution, or control gaps. • ... • Ability to analyze claims data, adjustment activity, claim samples, call recordings ...

Advantage Tech

Claims Specialist

Lees Summit, MO · Remote

$25/hr

... configuration, benefit interpretation, documentation, vendor execution, or control gaps. · Develop ... analyze claims data, adjustment activity, claim samples, call recordings, transcripts, audit ...

All JobsClaim Configuration Analyst JobsClaim Configuration Analyst Jobs in Missouri

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 Missouri? For Claim Configuration Analyst jobs in Missouri, the most frequently searched job titles are:
What job categories do people searching Claim Configuration Analyst jobs in Missouri look for? The top searched job categories for Claim Configuration Analyst jobs in Missouri are:
What cities in Missouri are hiring for Claim Configuration Analyst jobs? Cities in Missouri with the most Claim Configuration Analyst job openings:
Claim Configuration Analyst jobs near you
Infographic showing various Claim Configuration Analyst job openings in Missouri as of August 2026, with employment types broken down into 91% Full Time, and 9% Contract. Highlights an 74% In-person, and 26% Remote job distribution.

Medical Billing Specialist

Quest Health Solutions LLC

West Plains, MO • On-site

$17.50 - $22.50/hr

Full-time

Posted 26 days ago

Job description

Description:

Job Description – Medical Billing Specialist

Summary of the Role:

Reports to – Michele Herandez

Location – West Plains, MO

Hours – 8:00a - 4:30p M-F, Full time, In Office


Overview of the Role

Quest Health Solutions is seeking a detail-oriented and process-driven Insurance Systems & Configuration Specialist to support our Revenue Cycle and Resupply operations. This role is responsible for maintaining payer and insurance configuration accuracy within Brightree and related systems, ensuring clean claim flow, reducing billing issues, and supporting operational efficiency across teams.

Essential Duties and Responsibilities

  • Perform quality assurance reviews on insurance configurations and payer setups
  • Manage payer setup, maintenance, and configuration updates within Brightree
  • Configure, validate, and troubleshoot electronic claim (E-claim) setups
  • Review and correct payer addresses and insurance routing information
  • Identify and correct payer or insurance setup issues that could impact claims processing
  • Audit reorder insurance verifications for accuracy and completeness
  • Work and resolve Incomplete Demographic WIPs, including:
  • Missing policy numbers
  • Insurance policy changes or updates
  • Incomplete or invalid insurance information
  • Demographic discrepancies impacting order processing or billing

What You’ll Bring

  • DME & Insurance Operations Experience: Previous experience in healthcare revenue cycle management, DME, medical billing, insurance verification, or payer configuration. Strong understanding of payer structures, insurance workflows, and claim processing requirements.
  • Brightree & System Configuration Knowledge: Familiarity with Brightree, payer setup and maintenance, E-claim configuration, insurance validation workflows, and revenue cycle operations. Experience troubleshooting payer or configuration issues preferred.
  • Insurance Verification & Demographic Review Skills: Ability to review and resolve incomplete demographic and insurance-related WIPs, including missing policy numbers, insurance changes, invalid coverage information, and demographic discrepancies impacting billing or order processing.
  • Quality Assurance & Analytical Thinking: Strong attention to detail with the ability to audit insurance verifications, review payer configurations for accuracy, identify trends, and proactively resolve issues before they impact claims or operations.
  • Problem-Solving Ability: Demonstrated ability to research, analyze, and resolve complex insurance, payer, or claim routing issues efficiently while identifying root causes and process improvement opportunities.
  • Communication Skills: Strong verbal and written communication skills with the ability to collaborate effectively with internal teams and insurance providers to obtain and validate accurate information.
  • Organizational Skills: Excellent organizational and time management skills with the ability to manage multiple priorities, maintain accuracy in a fast-paced environment, and ensure timely follow-up and resolution of outstanding issues.

Why Quest Health Solutions

At Quest Health Solutions we are not just a company; we are a community committed to providing unparalleled service to our patients and their families. Our mission is rooted in compassion, excellence, and a drive to innovate in healthcare. We believe in creating a work environment that fosters growth, supports ambition, and values every individual's contribution.

We recognize our people drive everything we accomplish, and as such, we are dedicated to investing in our employees by fostering a culture of continuous learning, growth, and excellence.

Our team works hard, and we recognize the importance of taking care of ourselves. We offer a comprehensive suite of benefit offerings to support the health, well-being, and financial health of our employees and their families. Our robust benefits package underscores our commitment to our people, our most important asset.

Quest Health Solutions seeks excellence through diversity in its staff. We prohibit discrimination based on race, color, religion, sex, age, national origin, sexual orientation, gender identity or expression, disability, veteran status, or marital status.

Requirements: