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Claims Configuration Jobs in Virginia (NOW HIRING)

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

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

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

Lead Software Developer

Herndon, VA · On-site

$132K - $188K/yr

Medicare claims processing systems * Business rules engine development * Large-scale transaction ... YAML configuration management * Groovy scripting Software Development * Full Software Development ...

... claims, system administration, expansion business and member enrollment. The Manager of Pharmacy Benefits will be accountable for leading pharmacy benefit configuration for all products. Acts as a ...

... claims, system administration, expansion business and member enrollment. The Manager of Pharmacy Benefits will be accountable for leading pharmacy benefit configuration for all products. Acts as a ...

... claims, system administration, expansion business and member enrollment. The Manager of Pharmacy Benefits will be accountable for leading pharmacy benefit configuration for all products. Acts as a ...

... claims data, utilization trends, and vendor reporting to identify insights and support recommendations. * Support key annual initiatives including Open Enrollment, systems testing/configuration ...

Subcontractor Crews

Arlington, VA · On-site

$600 - $4.0K/wk

... fence configuration, or one of our expert installers - we know that you'll be fencing fantastic ... Applicant acknowledges, understands, and agrees that any claims, disputes, causes of action, of any ...

Ensure accurate system configuration within ADP and benefit platforms. * Manage eligibility, life ... Monitor claims experience and cost trends. * Analyze utilization data and recommend improvements.

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Showing results 1-20

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 Virginia? For Claims Configuration jobs in Virginia, the most frequently searched job titles are:
What job categories do people searching Claims Configuration jobs in Virginia look for? The top searched job categories for Claims Configuration jobs in Virginia are:
What cities in Virginia are hiring for Claims Configuration jobs? Cities in Virginia with the most Claims Configuration job openings:
Origami Risk Delivery Manager

Origami Risk Delivery Manager

Deloitte

Rosslyn, VA • On-site

Other

Posted 12 days ago


Deloitte rating

8.1

Company rating: 8.1 out of 10

Based on 90 frontline employees who took The Breakroom Quiz

59th of 148 rated financial services


Job description

Join our AI & Engineering team in transforming technology platforms, driving innovation, and helping make a significant impact on our clients' success. You'll work alongside talented professionals reimagining and re-engineering operations and processes that are critical to businesses. Your contributions can help clients improve financial performance, accelerate new digital ventures, and fuel growth through innovation.

AI & Engineering leverages cutting-edge engineering capabilities to build, deploy, and operate integrated/verticalized sector solutions in software, data, AI, network, and hybrid cloud infrastructure. These solutions are powered by engineering for business advantage, transforming mission-critical operations. We enable clients to stay ahead with the latest advancements by transforming engineering teams and modernizing technology & data platforms. Our delivery models are tailored to meet each client's unique requirements.

Recruiting for this role ends on 08/29/2026.

Work you'll do

As a Manager focused on Origami Risk Delivery on the Insurance Solutions team, you will be responsible for:

  • Leading package functional transformation engagements for insurance clients across strategy, design, implementation, and optimization activities
  • Translating business requirements into future-state process designs, platform configuration decisions, and implementation plans
  • Managing project workstreams, delivery teams, timelines, risks, and client communications throughout the delivery lifecycle
  • Collaborating with business, product, data, and engineering stakeholders to modernize core insurance operations and supporting functions
  • Driving implementation adoption through testing, deployment planning, training coordination, and post-launch stabilization

A successful candidate would possess these skills:

  • Ability to work independently and collaborate as part of a team
  • Effective written and verbal communication skills
  • Meticulous attention to detail and quality of work product
  • Ability to build and sustain professional relationships
  • Ability to lead projects or workstreams
  • Ability to manage and prioritize multiple tasks in a fast-paced and dynamic environment
  • Strong interpersonal skills and professional demeanor
  • Ability to meet deadlines
  • Ability to mentor and provide clear guidance to others

The team

Our Industry Solutions offering provides verticalized solutions that transform how clients sell products, deliver services, generate growth, and execute mission-critical operations. We deliver integrated business expertise with scalable, repeatable technology solutions specifically engineered for each sector.

The team collaborates with practitioners across Deloitte's different service offerings to deliver advice to formulate business strategy and strategic plans to leading insurance organizations and to implement solutions to execute on those plans and aid our clients in navigating complex engagements and organizational change.

Engagements span Deloitte offerings and could include developing underwriting, distribution, and claims transformation plans, modernizing specific business and enterprise functions, re-designing operating models and organizational structures, implementing digital experience and advanced analytics solutions, and integrating functions across multiple organizations. Our engagements require a combination of insurance industry knowledge, technical skill, and change management actions to instill confidence with our clients and execute the transformation. To enable our success, it will be critical to use data, insights, and new methods and technologies to inform better ways of working together.

Qualifications

Required:

  • Bachelor's degree
  • 6+ years of experience in package implementation, functional transformation, or technology-enabled business transformation
  • 3+ years of experience leading project workstreams or teams
  • Experience with insurance operations, claims, underwriting, or distribution transformation
  • Experience translating business requirements into platform design, configuration, or implementation plans
  • Ability to travel 50%, on average, based on the work you do and the clients and industries/sectors you serve.
  • Must be legally authorized to work in the United States without the need for employer sponsorship, now or at any time in the future.

Preferred:

  • Experience with Origami Risk, Guidewire, or Duck Creek
  • Experience leading insurance transformation programs
  • Experience with operating model design or organizational design
  • Experience with digital, data, or analytics-enabled transformation initiatives
  • Experience with enterprise platform modernization or system integration programs
  • Experience in a professional services or consulting environment

The wage range for this role takes into account the wide range of factors that are considered in making compensation decisions including but not limited to skill sets; experience and training; licensure and certifications; and other business and organizational needs. The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the position may be filled. At Deloitte, it is not typical for an individual to be hired at or near the top of the range for their role and compensation decisions are dependent on the facts and circumstances of each case. A reasonable estimate of the current range is $148,200 to $292,300.

You may also be eligible to participate in a discretionary annual incentive program, subject to the rules governing the program, whereby an award, if any, depends on various factors, including, without limitation, individual and organizational performance.

Qualifications:

Join our AI & Engineering team in transforming technology platforms, driving innovation, and helping make a significant impact on our clients' success. You'll work alongside talented professionals reimagining and re-engineering operations and processes that are critical to businesses. Your contributions can help clients improve financial performance, accelerate new digital ventures, and fuel growth through innovation.

AI & Engineering leverages cutting-edge engineering capabilities to build, deploy, and operate integrated/verticalized sector solutions in software, data, AI, network, and hybrid cloud infrastructure. These solutions are powered by engineering for business advantage, transforming mission-critical operations. We enable clients to stay ahead with the latest advancements by transforming engineering teams and modernizing technology & data platforms. Our delivery models are tailored to meet each client's unique requirements.

Recruiting for this role ends on 08/29/2026.

Work you'll do

As a Manager focused on Origami Risk Delivery on the Insurance Solutions team, you will be responsible for:

  • Leading package functional transformation engagements for insurance clients across strategy, design, implementation, and optimization activities
  • Translating business requirements into future-state process designs, platform configuration decisions, and implementation plans
  • Managing project workstreams, delivery teams, timelines, risks, and client communications throughout the delivery lifecycle
  • Collaborating with business, product, data, and engineering stakeholders to modernize core insurance operations and supporting functions
  • Driving implementation adoption through testing, deployment planning, training coordination, and post-launch stabilization

A successful candidate would possess these skills:

  • Ability to work independently and collaborate as part of a team
  • Effective written and verbal communication skills
  • Meticulous attention to detail and quality of work product
  • Ability to build and sustain professional relationships
  • Ability to lead projects or workstreams
  • Ability to manage and prioritize multiple tasks in a fast-paced and dynamic environment
  • Strong interpersonal skills and professional demeanor
  • Ability to meet deadlines
  • Ability to mentor and provide clear guidance to others

The team

Our Industry Solutions offering provides verticalized solutions that transform how clients sell products, deliver services, generate growth, and execute mission-critical operations. We deliver integrated business expertise with scalable, repeatable technology solutions specifically engineered for each sector.

The team collaborates with practitioners across Deloitte's different service offerings to deliver advice to formulate business strategy and strategic plans to leading insurance organizations and to implement solutions to execute on those plans and aid our clients in navigating complex engagements and organizational change.

Engagements span Deloitte offerings and could include developing underwriting, distribution, and claims transformation plans, modernizing specific business and enterprise functions, re-designing operating models and organizational structures, implementing digital experience and advanced analytics solutions, and integrating functions across multiple organizations. Our engagements require a combination of insurance industry knowledge, technical skill, and change management actions to instill confidence with our clients and execute the transformation. To enable our success, it will be critical to use data, insights, and new methods and technologies to inform better ways of working together.

Qualifications

Required:

  • Bachelor's degree
  • 6+ years of experience in package implementation, functional transformation, or technology-enabled business transformation
  • 3+ years of experience leading project workstreams or teams
  • Experience with insurance operations, claims, underwriting, or distribution transformation
  • Experience translating business requirements into platform design, configuration, or implementation plans
  • Ability to travel 50%, on average, based on the work you do and the clients and industries/sectors you serve.
  • Must be legally authorized to work in the United States without the need for employer sponsorship, now or at any time in the future.

Preferred:

  • Experience with Origami Risk, Guidewire, or Duck Creek
  • Experience leading insurance transformation programs
  • Experience with operating model design or organizational design
  • Experience with digital, data, or analytics-enabled transformation initiatives
  • Experience with enterprise platform modernization or system integration programs
  • Experience in a professional services or consulting environment

The wage range for this role takes into account the wide range of factors that are considered in making compensation decisions including but not limited to skill sets; experience and training; licensure and certifications; and other business and organizational needs. The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the position may be filled. At Deloitte, it is not typical for an individual to be hired at or near the top of the range for their role and compensation decisions are dependent on the facts and circumstances of each case. A reasonable estimate of the current range is $148,200 to $292,300.

You may also be eligible to participate in a discretionary annual incentive program, subject to the rules governing the program, whereby an award, if any, depends on various factors, including, without limitation, individual and organizational performance.

Education:Bachelor's DegreeEmployment Type:

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