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Claims Configuration Jobs in Connecticut (NOW HIRING)

Solution Architect

Rocky Hill, CT · On-site

$140 - $190/hr

We build the most advanced data-oriented claims platform in the industry, allowing insurance ... Draw clear lines between standard product, configuration, professional services, product ...

New

Systems Analyst I

Stamford, CT · On-site

  • Medical

  • Retirement

  • PTO

The Systems Analyst provides advanced analysis, workflow design, system configuration ... Strong understanding of Claims, Remittance, Clearinghouses, Payers and Plans.

Systems Analyst I

Stamford, CT · On-site +1

  • Medical

  • Retirement

  • PTO

The Systems Analyst provides advanced analysis, workflow design, system configuration ... Strong understanding of Claims, Remittance, Clearinghouses, Payers and Plans.

Guidewire PolicyCenter Sr Developer

Stamford, CT · On-site

$58 - $76.75/hr

Advanced degree in area of technical specialization CPCU, AIC, ARM Certification Guidewire Integration or Configuration certification 4 years experience with Guidewire Cloud Claims migration ...

Guidewire Architect

Stamford, CT

$64.75 - $84.25/hr

Advanced degree in area of technical specialization CPCU, AIC, ARM Certification Guidewire Integration or Configuration certification 4 years experience with Guidewire Cloud Claims migration ...

Solution Architect

Rocky Hill, CT · On-site +1

$60 - $79/hr

We build the most advanced data-oriented claims platform in the industry, allowing insurance ... OpenAPI/Swagger, authentication patterns, idempotency and error handling. • A configuration-first ...

Experience with insurance operations, claims, underwriting, or distribution transformation * Experience translating business requirements into platform design, configuration, or implementation plans

ServiceNow FSO Developer

Stamford, CT · On-site

$57.50 - $79.25/hr

... CMDB, Data models, etc. • Self-starter, good interpersonal skills, ability to lead customer ... Claims processing. • Around 1-2 years of working in ServiceNow FSO Projects and worked on ...

Partner with brokers and insurance carriers to resolve claims issues, billing discrepancies, and ... Hands-on experience with UKG, including benefits administration, Open Enrollment configuration, and ...

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Claims Configuration information

What is claims configuration?

Claims configuration refers to the process of setting up and maintaining the rules, parameters, and workflows in a healthcare or insurance system that determine how claims are processed, adjudicated, and paid. This role involves configuring software systems to ensure claims are handled accurately according to plan benefits, provider contracts, and regulatory requirements. Claims configuration specialists work closely with business analysts, IT, and operations teams to implement updates, troubleshoot issues, and support system enhancements. Their work helps streamline claims processing and minimize errors, ensuring compliance and customer satisfaction.

What are the key skills and qualifications needed to thrive as a claims configuration specialist?

To thrive as a Claims Configuration Specialist, you need a strong understanding of healthcare claims processing, benefits administration, and insurance terminology, often supported by a degree in healthcare administration or a related field. Familiarity with claims management systems (like Facets or QNXT), SQL, and sometimes certification in medical billing or claims adjudication is typically required. Attention to detail, analytical thinking, and effective communication are standout soft skills for this position. These abilities ensure accurate claims setup and processing, minimizing errors and supporting efficient healthcare operations.

What are the typical challenges faced in a claims configuration role, and how can they be effectively managed?

Professionals in Claims Configuration often encounter challenges such as interpreting complex insurance policies, keeping up with frequently changing healthcare regulations, and ensuring accuracy in system setups to prevent claims processing errors. To manage these challenges, strong analytical skills, attention to detail, and ongoing communication with cross-functional teams—such as IT, business analysts, and compliance—are essential. Staying current with regulatory updates and participating in regular training can also help maintain high-quality work and minimize costly claim rework.

What is the difference between Claims Configuration vs Claims Processing Specialist?

AspectClaims ConfigurationClaims Processing Specialist
Primary RoleSetting up and customizing claims systems and workflowsReviewing, adjudicating, and processing individual insurance claims
Required SkillsTechnical knowledge of claims systems, data managementAttention to detail, knowledge of claims policies, customer service
Work EnvironmentTypically in IT or claims system teams within insurance companiesIn claims departments, interacting directly with claimants and providers
CertificationsClaims system certifications, insurance knowledgeInsurance claims processing certifications, customer service training

Claims Configuration involves setting up and maintaining claims systems to ensure efficient processing, while Claims Processing Specialists handle the day-to-day review and adjudication of claims. Both roles are essential in the insurance industry but focus on different aspects of claims management.

What are popular job titles related to Claims Configuration jobs in Connecticut?

For Claims Configuration jobs in Connecticut, the most frequently searched job titles are:

What job categories do people searching Claims Configuration jobs in Connecticut look for?

The top searched job categories for Claims Configuration jobs in Connecticut are:

What cities in Connecticut are hiring for Claims Configuration jobs?

Cities in Connecticut with the most Claims Configuration job openings:

Project Manager - Claims Platform

Five Sigma

Rocky Hill, CT • On-site, Remote

Full-time

Posted 19 days ago


Job description

Description
Five Sigma is reinventing the way insurance claims are being handled. We are insurance and tech veterans who believe that efficiency is the name of the game. We build the most advanced data-oriented claims platform in the industry, allowing insurance companies to provide their customers the trust and experience they deserve
SUMMARY
We're looking to hire a Project Manager to join our Project Management team, within our Professional Services group. In this role, you will be responsible for launching new customers on Five Sigma SaaS platform, as well as dealing with the onboarding of existing customers. To accomplish that, the Project Manager works with our customers to build out the initial application configuration and review the primary settings and functionality of Five Sigma's platform and applications.
The Five Sigma Project manager is responsible for the overall management of a project throughout its lifecycle ensuring our projects fall within the applicable scope, time, and budget, and occasionally assists during the pre-sale engagement.
The Five Sigma Project manager can manage complex projects or smaller programs that require coordination of work between various parties like customer teams, Internal Five Sigma development and product teams, and other third parties that may be involved in a project.
The day-to-day of this role includes hosting kick-off calls to coordinate, plan, and measure the implementation of new clients and ensuring the client is on track with their onboarding process. This includes traveling to meet clients, engaging with their external and internal teams, understanding & documenting their business and technical requirements, managing the implementation of the Five Sigma platform, and transitioning the client to the Customer Support & Success team.
THE ROLE
• Conduct the project planning activities and manage the execution of large-scale, high-risk, or strategic projects from Initiating to successful go-live on time, scope and budget.
• Evaluate complex situations accurately and identify viable solutions that create successful outcomes for the customer.
• Manage relationships with project stakeholders, keeping them informed of progress and issues, in order to manage expectations on all project requirements and deliverables
• Ensure proper use of methodology, tools, and procedures
• Analyse risk, establish contingency plans and identify trigger events and responsibilities for initiating mitigating action
• Establish trust with clients by learning about their organization, processes, team member, and desired outcomes
• Work with a client's internal and external teams to understand the operational and technical requirements of the project
• Ensure the timely and successful completion of projects, as well as the transition to the customer support & success team post-production
• Work with the customer to create end-user training and establish support channels for go-live and post-production support
• Plan and manage the project resource allocation with relevant departments within the organization
• Ability to manage multiple projects and clients at one time
• Provide technical, business consulting, and product expertise to customers enabling comprehensive implementations and solutions
• Enable and configure various product features that meet the customer's needs within contractual constraints or identify change requests when needed
• Identify use cases, roles, and other business requirements for each implementation
Requirements
ROLE REQUIREMENTS
• More than 5 years of project management experience in Insurtech large-scale strategic projects - must
• Knowledge of and competency in project management processes including planning tasks, resource allocation, risk management, time management, financial management, quality management, monitoring and reporting, documenting and record keeping
• Strong leadership, organizational and interpersonal skills; the ability to work well with people from different disciplines with varying degrees of technical experience; competence in clear concise, and tactful communication with senior executive management, clients, peers, and team members
• Proven ability to manage multiple projects at a time with multiple constituents
• Strong client-facing and internal communication skills
• Strong written and verbal communication skills
• Strong organizational skills including attention to detail and multi-tasking skills
• Experience in writing functional (business & technical) requirements
• Experience in delivering client-focused solutions based on customer needs that fit within the scope of the project and statement of work
• Strong technical background and technical understanding.
• Demonstrated experience leading cross-functional teams within a formalized methodology
• PMP certification and /or other industry and project management certifications are an additional benefit
• Location: North America
Salary Range: 160-180 K USD