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Claim Configuration Analyst Jobs in Tennessee (NOW HIRING)

... analysis, configuration review, workflow sessions, and customer training activities to support implementation readiness. * Support RCM-related EHR configuration activities, including claim setup ...

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 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 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.

Is claims processing a stressful job?

Claims processing as a Claim Configuration Analyst can be stressful due to tight deadlines, high accuracy requirements, and the need to resolve complex issues efficiently. The role often involves detailed data analysis and communication with stakeholders, which can contribute to work-related stress. 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 Tennessee?

For Claim Configuration Analyst jobs in Tennessee, the most frequently searched job titles are:

What job categories do people searching Claim Configuration Analyst jobs in Tennessee look for?

The top searched job categories for Claim Configuration Analyst jobs in Tennessee are:

What cities in Tennessee are hiring for Claim Configuration Analyst jobs?

Cities in Tennessee with the most Claim Configuration Analyst job openings:

Sr Application Analyst, Claims Systems

Elevance Health

Nashville, TN • On-site

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 2 days ago

New


Elevance Health rating

7.5

Company rating: 7.5 out of 10

Based on 354 frontline employees who took The Breakroom Quiz

218th of 315 rated insurance


Job description

Anticipated End Date:

2026-09-12

Position Title:

Sr Application Analyst, Claims Systems

Job Description:

JR205511 Sr Application Analyst, Claims Systems

CareBridge Health is a proud member of the Elevance Health family of companies, within our Carelon business. CareBridge Health exists to enable individuals in home and community-based settings to maximize their health, independence, and quality of life through home-care and community based services.

CareBridge is seeking a Sr Application Analyst, Claims Systems professional, to support reporting, analytics, and process improvements across the claims lifecycle. In this role, you'll use your provider-side claims, EHR/revenue cycle, and SQL/data expertise to turn complex data into actionable insights, support claim corrections, troubleshoot claims workflows, and improve processes.

You'll build reporting solutions, enhance submission performance, and partner with Product, Engineering, Finance, and Operations to improve and scale end-to-end claims processes.

Location: Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions (when indicated), providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development.

Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless accommodation is granted as required by law.

How you will make an impact:

Claims & Encounter Reporting

  • Build and maintain reporting to track the full claims lifecycle from submission to payer response.

  • Create self-service tools for Operations, Finance, and Client Success.

  • Reconcile data across systems to ensure accurate claim status tracking.

Claims Subject Matter Expertise

  • Act as an SME on claims structure, clearinghouse workflows, and payer responses.

  • Support complex claim issues and partner with Product and Engineering to resolve data/workflow gaps and validate fixes.

Payer Configuration & Onboarding

  • Support new payer implementations, including workflow setup and validation.

  • Develop standardized monitoring for go-lives and streamline payer-specific processes.

Process Improvement & Operations

  • Identify and resolve recurring submission issues.

  • Partner cross-functionally to improve workflows, tools, and documentation.

  • Support audits and quality reviews.

Minimum Requirements:

  • Requires an BA/BS degree in Information Technology, Computer Science or related field of study and a minimum of 6 years systems analyst or business analyst experience; or any combination of education and experience, which would provide an equivalent background.

Preferred Skills, Capabilities and Experiences:

  • 5+ years of experience in provider-side claims, revenue cycle, or data management.

  • 2+ years of experience working with EHR systems, revenue cycle, and billing platforms, with provider-side claims experience strongly preferred.

  • Strong understanding of professional claim formats (837P), remittance advice (835), and clearinghouse workflows.

  • Advanced SQL skills with experience querying complex healthcare production or analytics databases.

  • Hands-on experience within a claims platform, including claim correction, resubmission, and configuration validation.

  • Experience developing reports and dashboards using BI tools (e.g., Tableau, Power BI, Metabase)

  • Ability to translate complex data into clear, actionable insights for business stakeholders.

  • Strong cross-functional communication skills with experience partnering across Product, Engineering, Finance, and Operations.

  • Experience working in value-based care environments.

  • Candidates from all states are welcome.

Job Level:

Non-Management Exempt

Workshift:

Job Family:

IFT > IT Bus Systems Solutions Planning

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.


Who We Are

Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.


How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.


We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.


Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.


The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.


Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process should submit the following form: Accessibility Accommodation Request Form and a member of the team will be in contact. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.


Prospective employees required to be screened under Florida law should review the education and awareness resources at HB531 | Florida Agency for Health Care Administration.


NOTE: Workday keeps job postings active through 11:59:59 PM on the day before the listed end date. Example: If the end date is 3/13, the posting will automatically come down on 3/12 at 11:59:59 PM. In other words - the job is posted until 3/13, not through 3/13.


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About Elevance Health

Sourced by ZipRecruiter

Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. A Fortune 20 company with a longstanding history in the healthcare industry, we are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Indianapolis, IN, US

Year founded

2004

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