Claim Configuration Analyst Jobs in Virginia (NOW HIRING)

About the role
As a NetworX Configuration Analyst, you will make an impact by configuring and maintaining complex provider pricing arrangements within the TriZetto Facets Integrated NetworX platform. You will be a valued member of the Configuration team and work collaboratively with claims operations, provider contracting, business stakeholders, and technical teams to ensure accurate claim pricing and payment outcomes.
In this role, you will translate provider contract language into system configurations, support pricing implementations, and help ensure compliance with healthcare reimbursement requirements. Depending on experience, you may also provide mentorship to team members, lead conversion initiatives, and support configuration best practices across the organization.
In this role, you will:
Configure, maintain, and optimize provider pricing arrangements within the TriZetto Facets Integrated NetworX platform.
Analyze managed care contracts and translate contract terms into fee schedules, rate tables, qualifiers, and system configuration rules.
Perform configuration validation, unit testing, regression testing, and end-to-end testing to ensure accurate claim adjudication and payment outcomes.
Utilize Oracle SQL and relational database tools to audit, validate, troubleshoot, and reconcile configuration data.
Partner with provider contracting, claims operations, and business stakeholders to support contract implementations, system migrations, and pricing updates.
Monitor and implement regulatory and reimbursement updates, including CMS, Medicare, and Medicaid pricing changes.
Support configuration projects by identifying risks, resolving issues, and ensuring timely delivery of high-quality solutions.
Mentor junior analysts and contribute to knowledge sharing and continuous improvement initiatives across the configuration team.
Work model
We strive to provide flexibility wherever possible. Based on this role's business requirements, this is a remote position open to qualified applicants. Regardless of your working arrangement, we are here to support a healthy work-life balance through our various wellbeing programs.
The working arrangements for this role are accurate as of the date of posting. This may change based on the project you're engaged in, as well as business and client requirements. Rest assured; we will always be clear about role expectations.
What you need to have to be considered
Experience configuring and maintaining pricing arrangements within TriZetto Facets Integrated NetworX (INX).
Strong knowledge of healthcare payer operations, provider contracts, and reimbursement methodologies.
Experience reviewing and interpreting provider agreements, fee schedules, and reimbursement terms.
Advanced Oracle SQL skills with experience querying and validating large datasets.
Experience performing contract testing, configuration testing, migration validation, and production support activities.
Understanding of claims processing, claim adjudication, and pricing workflows within healthcare environments.
Ability to troubleshoot complex configuration issues and identify root causes.
Strong analytical and problem-solving skills with exceptional attention to detail.
Excellent written and verbal communication skills and the ability to collaborate with cross-functional teams.
These will help you stand out
Experience with Facets platform conversions, implementations, or migration projects.
Familiarity with CMS, Medicare, Medicaid, and other healthcare reimbursement regulations.
Experience establishing pricing hierarchy logic, exception handling, and provider-specific pricing rules.
Knowledge of healthcare data analysis, reporting, and audit processes.
Experience mentoring configuration analysts or leading workstreams within a collaborative team environment.
Exposure to provider network management, contract loading, or claims operations functions.
Proven ability to manage multiple priorities while maintaining high levels of accuracy and quality.
Applicants will be accepted till 08/30/2026
Cognizant will only consider applicants for this position who are legally authorized to work in the United States without company sponsorship.
*Please note, this role is not able to offer visa transfer or sponsorship now or in the future*
The annual salary for this position will be in the range of $99K - $115K depending on experience and other qualifications of the successful candidate
This position is also eligible for Cognizant's discretionary annual incentive program, based on performance and subject to the terms of Cognizant's applicable plans.
Benefits: Cognizant offers the following benefits for this position, subject to applicable eligibility requirements:
Medical/Dental/Vision/Life Insurance
Paid holidays plus Paid Time Off
401(k) plan and contributions
Long-term/Short-term Disability
Paid Parental Leave
Employee Stock Purchase Plan
We're excited to meet people who share our mission and can make an impact in a variety of ways. Don't hesitate to apply, even if you only meet the minimum requirements listed. Think about your transferable experiences and unique skills that make you stand out as someone who can bring new and exciting things to this role.
About Cognizant:
Cognizant (Nasdaq: CTSH) is an AI Builder and technology services provider, bridging the gap between AI investment and enterprise value by building full-stack AI solutions for our clients. Our deep industry, process and engineering expertise enables us to build an organization's unique context into technology systems that amplify human potential, drive tangible outcomes and keep global enterprises ahead in a fast-changing world. See how at cognizant.ai or @cognizant.
Additional employment information
Compensation information is accurate as of the date of this posting. Cognizant reserves the right to modify this information at any time, subject to applicable law.
Applicants may be required to attend interviews in person or by video conference. In addition, candidates may be required to present their current state or government issued ID during each interview.
Cognizant is an equal opportunity employer. Your application and candidacy will not be considered based on race, color, sex, religion, creed, sexual orientation, gender identity, national origin, disability, genetic information, pregnancy, veteran status or any other characteristic protected by federal, state or local laws.
If you have a disability that requires reasonable accommodation to search for a job opening or submit an application, please email [email protected] for roles based in the Americas or [email protected] for roles based in India.