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Claims Configuration Jobs in Indiana (NOW HIRING)

... claims, billing edits, and workflows. * Analyze business and billing requirements and translate them into Epic system build and configuration. * Support end-to-end revenue cycle workflows including ...

Guidewire Architect

Indianapolis, IN

$60.25 - $79.25/hr

CPCU, AIC, ARM, and/or Guidewire Integration or Configuration certification * 4+ years of experience with Guidewire Cloud Claims migration * Experience delivering projects using Agile/Scrum ...

New

... configuration of AI tools in alignment with MedPro policies. Qualifications : Required : • ... MedPro Group is the national leader in customized insurance, claims, patient safety, and risk ...

... claims adjudicator. * Analyze, design, and develop specifications for enhancements and extensions with application interfaces and maps. Ensure proper configuration and setup of data that support file ...

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Claims Configuration information

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 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 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, and why are they important?

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 popular job titles related to Claims Configuration jobs in Indiana? For Claims Configuration jobs in Indiana, the most frequently searched job titles are:
What job categories do people searching Claims Configuration jobs in Indiana look for? The top searched job categories for Claims Configuration jobs in Indiana are:
What cities in Indiana are hiring for Claims Configuration jobs? Cities in Indiana with the most Claims Configuration job openings:
Supplemental Health Claims Consultant

Supplemental Health Claims Consultant

OneAmerica

Indianapolis, IN • On-site, Remote

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 11 hours ago


OneAmerica Financial rating

8.5

Company rating: 8.5 out of 10

Based on 5 frontline employees who took The Breakroom Quiz


Job description

At OneAmerica Financial, our purpose is to create more certainty for our customers that leads to better moments, every day. Our commitment is to advance stability and growth in every solution and relationship.  We deliver financial strength that builds for generations, and we are always aspiring, looking ahead, and collaborating to achieve more, together.  Come be a part of this journey with us as we champion lives!

The Supplemental Health Claims Consultant is an individual contributor responsible for providing subject matter expertise to design, implement, and continuously improve supplemental health claims processes, procedures, and workflows. This role partners closely with Claims Operations, Product, Compliance, Training, and Technology teams to ensure customer-focused, compliant, and efficient claims practices. The position may also adjudicate claims and support quality initiatives as needed.

Key Responsibilities: 

  • Process, procedure, and workflow design: Lead the development and implementation of new and revised supplemental health claims processes, standard operating procedures (SOPs), desk-level job aids, workflow diagrams, and controls to support consistent, scalable operations.
  • Technical claims subject matter expertise: Serve as the go-to expert for supplemental health products (Accident, Critical Illness, Hospital Indemnity, Wellness, etc.) and interpret plan provisions, definitions, limitations, exclusions, riders, and administrative rules to guide accurate claims outcomes.
  • Systems design and requirements support: Partner with Technology and business stakeholders to translate operational needs into clear requirements (rules, routing, templates, decision logic, edits, and reporting), validate design, and support testing (UAT) to ensure systems enable compliant and efficient claims processing.
  • Eligibility and efficiency optimization: Identify opportunities to improve eligibility verification, evidence collection, and straight-through processing; recommend automation and controls to reduce rework, turnaround time, and preventable denials while maintaining accuracy and customer experience.
  • Training and knowledge enablement: Contribute to training program development by creating curriculum content, job aids, and scenario-based learning; deliver or support training for new hires and tenured staff on product knowledge, systems, and procedure changes.
  • Continuous improvement and quality: Analyze operational performance (e.g., turnaround time, accuracy, denial drivers, customer contacts), support root-cause investigations, and implement corrective actions; participate in audits and quality reviews to sustain high standards.
  • Regulatory compliance and industry awareness: Stay current on applicable federal/state regulations, market trends, and internal compliance requirements; assess impacts to claims handling and proactively recommend updates to procedures, controls, training, and communications.
  • Claims adjudication (as assigned): Review and adjudicate supplemental health claims in accordance with plan provisions and procedures

Required Qualifications

  • Bachelor’s degree (or equivalent combination of education and related experience).
  • 3+ years of experience in supplemental health (voluntary benefits) claims operations and/or claims adjudication (Accident, Critical Illness, Hospital Indemnity, Wellness, etc.).
  • Experience with process improvement methods, service-level management, and quality/audit programs.
  • Experience creating and maintaining operational documentation (SOPs, workflows, job aids) and communicating process changes to stakeholders.
  • Experience supporting implementations or migrations of claims platforms (requirements, configuration support, testing, training, go-live readiness).
  • Demonstrated training facilitation experience (live sessions, virtual training, train-the-trainer).
  • Demonstrated ability to interpret plan provisions/contract language and apply it consistently to claim scenarios.
  • Working knowledge of claims systems and operational controls (queue routing, decision rules, correspondence templates, work item management) and participation in testing/UAT.
  • Ability to analyze operational issues, identify root causes, and implement improvements that enhance accuracy, compliance, and cycle time.
  • Strong written and verbal communication skills, with the ability to explain claim outcomes and technical concepts clearly and professionally.

Preferred Qualifications

  • Experience applying Lean and Six Sigma methodologies to drive process improvements
  • Experience with FINEOS (Claims, Admin Platform - Any product) 

Salary Band: 6A

#LI-SC1

This selected candidate will be expected to work hybrid in Indianapolis, IN or Portland, ME but we may consider remote associates who are not local to Indianapolis, IN or Portland, ME. The candidate will also be expected to physically return to the office in CA, IN or ME as business needs dictate or for team building and collaboration.

Consistent with applicable pay transparency laws, we disclose the compensation range for this position: $66,000 – $110,000 annually. Actual compensation will be determined by factors such as education, experience, geographical location, and other job-related factors permitted by law. In addition to base pay, this role is eligible for an annual incentive program.

We offer a comprehensive total rewards package designed to support you both at work and at home. Fulltime and parttime associates working 30 or more hours per week are generally eligible for benefits, including but not limited to:

  • Medical & prescription, dental, vision insurance
  • Health Savings Account & Flexible Spending Accounts
  • Paid Time Off
  • 10 weeks 100% paid parental leave (after completing 12 months of employment)
  • 401(k) Plan with company match
  • Pension Plan
  • Company paid life & disability insurance
  • Wellness Program & Company paid employee assistance program
  • Clinic access subject to location* (*Indianapolis, Charlotte, Cincinnati)

If you are offered and accept this position, please be advised that OneAmerica Financial does not have any offices located in the State of New York and OneAmerica Financial associates are not permitted to work remotely in the State of New York.

Selected employees must be able to perform the essential functions of the position satisfactorily and, if requested, reasonable accommodations will be made to enable employees with disabilities to perform the essential functions of their job, absent undue hardship. 

Disclaimer:  American United Life Insurance Company (“OneAmerica Financial”) is committed to a policy of Equal Employment Opportunity and will not discriminate against an applicant or employee based on race, color, religion, creed, national origin or ancestry, ethnicity, sex (including gender, pregnancy, sexual orientation, gender identity), age, physical or mental disability, veteran or military status, genetic information, citizenship, or any other legally recognized protected basis under federal, state, or local law.

For all positions:

Because this position is regulated by the Violent Crime Control and Law Enforcement Act, if an offer is made, applicants must undergo mandated background checks as a condition of employment. Such background checks include criminal history. A conviction is not necessarily an absolute bar to employment. Consistent with applicable regulatory guidelines and law, factors such as the age of the offense, evidence of rehabilitation, seriousness of violation, and job relatedness are considered.

To learn more about our products, services, and the companies of OneAmerica Financial, visit oneamerica.com/companies.


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