Experience supporting implementations or migrations of claims platforms (requirements, configuration support, testing, training, go-live readiness). * Demonstrated training facilitation experience ...
Experience supporting implementations or migrations of claims platforms (requirements, configuration support, testing, training, go-live readiness). * Demonstrated training facilitation experience ...
Experience supporting implementations or migrations of claims platforms (requirements, configuration support, testing, training, go-live readiness). * Demonstrated training facilitation experience ...
Quick apply
Experience supporting implementations or migrations of claims platforms (requirements, configuration support, testing, training, go-live readiness). * Demonstrated training facilitation experience ...
Experience supporting implementations or migrations of claims platforms (requirements, configuration support, testing, training, go-live readiness). * Demonstrated training facilitation experience ...
Experience supporting implementations or migrations of claims platforms (requirements, configuration support, testing, training, go-live readiness). * Demonstrated training facilitation experience ...
Epic HB Analyst
Zionsville, IN · On-site
... 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 ...
Quick apply
Epic HB Analyst
Zionsville, IN · On-site
... 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
$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
Guidewire Architect
$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
Experience with insurance operations, claims, underwriting, or distribution transformation * Experience translating business requirements into platform design, configuration, or implementation plans
New
Experience with insurance operations, claims, underwriting, or distribution transformation * Experience translating business requirements into platform design, configuration, or implementation plans
New
AI Specialist
Fort Wayne, IN · On-site
... 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 ...
AI Specialist
Fort Wayne, IN · On-site
... 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 ...
Lead provider operations functions such as credentialing, contract configuration, and provider data ... Claims, and other operational areas. * Collaborate with business development, sales, marketing ...
Lead provider operations functions such as credentialing, contract configuration, and provider data ... Claims, and other operational areas. * Collaborate with business development, sales, marketing ...
Lead provider operations functions such as credentialing, contract configuration, and provider data ... Claims, and other operational areas. * Collaborate with business development, sales, marketing ...
Lead provider operations functions such as credentialing, contract configuration, and provider data ... Claims, and other operational areas. * Collaborate with business development, sales, marketing ...
Lead provider operations functions such as credentialing, contract configuration, and provider data ... Claims, and other operational areas. * Collaborate with business development, sales, marketing ...
Lead provider operations functions such as credentialing, contract configuration, and provider data ... Claims, and other operational areas. * Collaborate with business development, sales, marketing ...
Technical Account Manager
Washington, IN · On-site +1
... 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 ...
Technical Account Manager
Washington, IN · On-site +1
... 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 ...
... 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 ...
New
... 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 ...
New
Business Analyst - Healthcare
Indianapolis, IN · On-site
$55K - $79K/yr
... configuration. What we're looking for * 3+ years as a Business Analyst with healthcare claims experience required. * A Certified coder is preferred * Proficiency in CPT, HCPCS, and ICD-10 coding
Business Analyst - Healthcare
Indianapolis, IN · On-site
$55K - $79K/yr
... configuration. What we're looking for * 3+ years as a Business Analyst with healthcare claims experience required. * A Certified coder is preferred * Proficiency in CPT, HCPCS, and ICD-10 coding
Business Analyst - Healthcare
Indianapolis, IN · On-site
$55K - $79K/yr
... configuration. What we're looking for * 3+ years as a Business Analyst with healthcare claims experience required. * A Certified coder is preferred * Proficiency in CPT, HCPCS, and ICD-10 coding
Business Analyst - Healthcare
Indianapolis, IN · On-site
$55K - $79K/yr
... configuration. What we're looking for * 3+ years as a Business Analyst with healthcare claims experience required. * A Certified coder is preferred * Proficiency in CPT, HCPCS, and ICD-10 coding
Epic Revenue Cycle Scheduling & Registration Analyst
Terre Haute, IN · On-site
$17.25 - $22.75/hr
The Epic Cadence & Prelude Analyst supports the configuration, implementation, and optimization of ... General understanding of revenue cycle operations, including registration, billing, claims ...
Epic Revenue Cycle Scheduling & Registration Analyst
Terre Haute, IN · On-site
$17.25 - $22.75/hr
The Epic Cadence & Prelude Analyst supports the configuration, implementation, and optimization of ... General understanding of revenue cycle operations, including registration, billing, claims ...
The Epic Cadence & Prelude Analyst supports the configuration, implementation, and optimization of ... General understanding of revenue cycle operations, including registration, billing, claims ...
The Epic Cadence & Prelude Analyst supports the configuration, implementation, and optimization of ... General understanding of revenue cycle operations, including registration, billing, claims ...
Epic Revenue Cycle Scheduling & Registration Analyst
$17.25 - $22.75/hr
The Epic Cadence & Prelude Analyst supports the configuration, implementation, and optimization of ... General understanding of revenue cycle operations, including registration, billing, claims ...
Epic Revenue Cycle Scheduling & Registration Analyst
$17.25 - $22.75/hr
The Epic Cadence & Prelude Analyst supports the configuration, implementation, and optimization of ... General understanding of revenue cycle operations, including registration, billing, claims ...
Epic Revenue Cycle Scheduling & Registration Analyst
Terre Haute, IN · On-site
$17.25 - $22.75/hr
The Epic Cadence & Prelude Analyst supports the configuration, implementation, and optimization of ... General understanding of revenue cycle operations, including registration, billing, claims ...
Epic Revenue Cycle Scheduling & Registration Analyst
Terre Haute, IN · On-site
$17.25 - $22.75/hr
The Epic Cadence & Prelude Analyst supports the configuration, implementation, and optimization of ... General understanding of revenue cycle operations, including registration, billing, claims ...
The Epic Cadence & Prelude Analyst supports the configuration, implementation, and optimization of ... General understanding of revenue cycle operations, including registration, billing, claims ...
The Epic Cadence & Prelude Analyst supports the configuration, implementation, and optimization of ... General understanding of revenue cycle operations, including registration, billing, claims ...
The Epic Cadence & Prelude Analyst supports the configuration, implementation, and optimization of ... General understanding of revenue cycle operations, including registration, billing, claims ...
The Epic Cadence & Prelude Analyst supports the configuration, implementation, and optimization of ... General understanding of revenue cycle operations, including registration, billing, claims ...
Claims Configuration information
What is the difference between Claims Configuration vs Claims Processing Specialist?
| Aspect | Claims Configuration | Claims Processing Specialist |
|---|---|---|
| Primary Role | Setting up and customizing claims systems and workflows | Reviewing, adjudicating, and processing individual insurance claims |
| Required Skills | Technical knowledge of claims systems, data management | Attention to detail, knowledge of claims policies, customer service |
| Work Environment | Typically in IT or claims system teams within insurance companies | In claims departments, interacting directly with claimants and providers |
| Certifications | Claims system certifications, insurance knowledge | Insurance 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?
What is claims configuration?
What are the key skills and qualifications needed to thrive as a Claims Configuration Specialist, and why are they important?
Full-time
Medical, Dental, Vision, Life, Retirement, PTO
Posted 11 hours ago
OneAmerica Financial rating
8.5
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.