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Claim Configuration Analyst Jobs in Phoenix, AZ (NOW HIRING)

BrightSpring

Billing Readiness Specialist

Phoenix, AZ · On-site

$18.50 - $25/hr

Ability to analyze payer setup and account configuration discrepancies * Strong communication and ... Improvement in clean claim submission rates * Accuracy of patient responsibility configuration

Personify Health

Senior Claims Specialist

Tempe, AZ · On-site

$22 - $25/hr

Every claim processed correctly protects the organization from costly errors and ensures members ... Review, analyze, and process complex healthcare, dialysis, and stop loss claims with a level of ...

Personify Health

Senior Claims Specialist

Tempe, AZ · On-site

$22 - $25/hr

Every claim processed correctly protects the organization from costly errors and ensures members ... Review, analyze, and process complex healthcare, dialysis, and stop loss claims with a level of ...

Personify Health

Senior Claims Specialist

Tempe, AZ · On-site

$22 - $25/hr

Every claim processed correctly protects the organization from costly errors and ensures members ... Review, analyze, and process complex healthcare, dialysis, and stop loss claims with a level of ...

Personify Health

Senior Claims Specialist

Tempe, AZ · On-site

$22 - $25/hr

Every claim processed correctly protects the organization from costly errors and ensures members ... Review, analyze, and process complex healthcare, dialysis, and stop loss claims with a level of ...

Maricopa

Billing Claims Administrator

Phoenix, AZ · On-site

$65 - $85/hr

... configuration roles, fee schedules, CPT codes, modifiers, templates, claim scrubbing, and automated rule engines. * Conduct and provide analysis along with recommendations to department leadership

Maricopa

Billing Claims Administrator

Phoenix, AZ · On-site

$65K - $104K/yr

... configuration roles, fee schedules, CPT codes, modifiers, templates, claim scrubbing, and automated rule engines. Conduct and provide analysis along with recommendations to department leadership

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Claim Configuration Analyst information

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$15

$41

$68

How much do claim configuration analyst jobs pay per hour?

As of Sep 4, 2026, the average hourly pay for claim configuration analyst in Phoenix, AZ is $41.02, according to ZipRecruiter salary data. Most workers in this role earn between $30.29 and $52.50 per hour, depending on experience, location, and employer.

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.

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

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The top searched job categories for Claim Configuration Analyst jobs in Phoenix, AZ are:

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Cities near Phoenix, AZ with the most Claim Configuration Analyst job openings:

Claim Configuration Analyst jobs near you
Infographic showing various Claim Configuration Analyst job openings in Phoenix, AZ as of August 2026, with employment types broken down into 87% Full Time, 8% Part Time, and 5% Contract. Highlights an 84% Physical, 6% Hybrid, and 10% Remote job distribution, with an average salary of $85,326 per year, or $41 per hour.

Senior Configuration Quality Audit Analyst

Personify Health

Tempe, AZ • On-site

Full-time

Medical, Dental, Retirement, PTO

Posted 18 days ago

Key responsibilities

  • Lead configuration audits by reviewing and validating complex claims system configurations against client requirements, provider contracts, benefit plans, fee schedules, and regulatory guidelines.

  • Translate plan language, including Summary Plan Descriptions and contractual agreements, into precise system rules, benefit matrices, and cost-sharing structures.

  • Review and validate configuration changes related to member enrollment, provider contracts, plan design, and claims processing before implementation.

Job description

Overview
Who We Are
Because health is personal. That's why Personify Health created the first and only personalized health platform-bringing health plan administration, holistic wellbeing solutions, and comprehensive care navigation together in one place. We serve employers, health plans, and health systems with data-driven solutions that reduce costs while actually improving health outcomes. Together, our team is on a mission to empower people to lead healthier lives.
Learn even more about the work that drives us at personifyhealth.com.
Responsibilities
Ready to make sure every claim gets it right?
Why This Role Matters
Every claim that runs through our system tells a real story - a member getting the care they need, a provider getting paid correctly, a client trusting that their plan is doing what it's supposed to do. This role is the safeguard behind that trust: catching configuration errors before they become member complaints, compliance gaps, or costly rework. When benefit plans, fee schedules, and adjudication rules are set up right, claims process faster, auto-adjudication rates climb, and clients stop worrying and start relying on us. The audits and root-cause fixes this person drives don't just clean up today's errors - they prevent tomorrow's. Get this right, and the whole claims operation runs smoother, faster, and more accurately, directly moving the needle on the outcomes clients and members actually feel.
What You'll Actually Do
  • Lead configuration audits: Own the end-to-end audit and validation of complex claims system configurations, confirming accuracy against client requirements, provider contracts, benefit plans, fee schedules, and regulatory guidelines.
  • Translate plan language into system logic: Interpret Summary Plan Descriptions (SPDs), client-specific requirements, and contractual agreements, converting them into precise system rules, benefit matrices, and cost-sharing structures.
  • Validate configuration changes: Review updates to member enrollment, provider contracts, plan design, claims processing guidelines, and system enhancements before they go live.
  • Analyze claims for accuracy: Dig into complex institutional and professional claims to verify configuration, adjudication logic, and processing outcomes are working as intended.
  • Resolve configuration issues at the root: Research and troubleshoot claim adjudication and configuration problems, tracing them to root cause and recommending fixes that stick.
  • Build test strategies: Develop test cases and audit methodologies that support system enhancements, configuration updates, and process improvements.
  • Improve auto-adjudication rates: Evaluate automated configuration solutions and identify opportunities to boost accuracy, efficiency, and straight-through processing.
  • Report on quality and risk: Prepare and maintain audit results, quality metrics, and ad hoc reports that give leadership what they need to make informed decisions.
  • Share findings that drive change: Communicate audit findings, trends, risks, and recommendations to internal stakeholders and leadership in a way that leads to action.
  • Set the standard for audit quality: Provide subject matter expertise and mentoring to peers, helping shape audit standards, quality controls, and best practices across the team.
  • Support compliance and process initiatives: Participate in cross-functional efforts focused on compliance, operational excellence, and system optimization.
  • Uphold regulatory and data standards: Ensure ongoing adherence to HIPAA, claim processing requirements, and data integrity controls.

Qualifications
What You Bring to Our Team
Education & Experience:
  • Bachelor's degree in Healthcare Administration, Business, Information Systems, or a related field, or an equivalent combination of education and experience
  • 3+ years of progressive experience in claims configuration, claims auditing, quality assurance, benefits administration, or related healthcare operations
  • Experience in self-funded health plans, third-party administration (TPA), healthcare payer operations, or managed care environments preferred

Technical Skills:
  • Advanced experience working within the Javelina claims processing platform or similar core claims administration systems
  • Experience interpreting Summary Plan Descriptions (SPDs), provider contracts, and benefit plan designs
  • Demonstrated experience performing complex claims analysis, system testing, auditing, and root cause investigation

The professional qualities:
  • Flexibility to meet changing business requirements with strong commitment to high-quality, on-time delivery
  • Excellent communication skills for presenting audit findings to diverse stakeholders
  • Problem-solving mindset with ability to recommend solutions that improve auto-adjudication efficiency
  • Collaborative approach to working with cross-functional teams on system updates and configuration changes

Benefits
The Highlights:
  • Competitive base salary and benefits effective day one
  • Comprehensive medical and dental through our own health solutions (yes, we use what we build)
  • Paid Time Off-rest and recharge time is non-negotiable
  • Mental health support, retirement planning, and financial protection
  • Professional development with clear career progression and learning budgets
  • Mission-driven culture where diverse perspectives drive real impact on people's health

Want the full picture? Visit personifyhealthbenefits.com to explore our complete benefits package, wellness programs, and other employee perks.
Compensation: This position offers a base salary range of $70,000-$83,000 annually, depending on location, skills, and experience. You're eligible for our full benefits package starting day one.
Our Commitment: Personify Health is an equal opportunity employer committed to diversity, equity, inclusion, and belonging. We cultivate a work environment where differences are celebrated, and employees of all backgrounds are empowered to thrive-because diversity is core to who we are and critical to our work in health and wellbeing.
Stay Safe: Personify Health will never ask for payment or sensitive personal information like social security numbers during hiring. All official communication comes from verified company email addresses and or our secure applicant tracking system. Suspicious requests? Report them to talent@personifyhealth.com. View all legitimate openings at personifyhealth.com/careers.

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