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Claims Configuration Jobs in Silver Spring, MD (NOW HIRING)

Familiarity with claims systems, configuration processes, or policy governance. Knowledge, Skills and Abilities (KSAs) * Strong organizational and coordination skills across multiple teams and ...

Participate in configuration, customization, and development of standards-based HL7, X12, and ... Analyze financial and administrative workflows including claims, remittances, eligibility, payment ...

... 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 ...

Showing results 41-60

Claims Configuration information

See Silver Spring, MD salary details

$36.2K

$90.8K

$143.7K

How much do claims configuration jobs pay per year?

As of Aug 19, 2026, the average yearly pay for claims configuration in Silver Spring, MD is $90,829.00, according to ZipRecruiter salary data. Most workers in this role earn between $70,300.00 and $108,500.00 per year, depending on experience, location, and employer.

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 Silver Spring, MD?

For Claims Configuration jobs in Silver Spring, MD, the most frequently searched job titles are:

What job categories do people searching Claims Configuration jobs in Silver Spring, MD look for?

The top searched job categories for Claims Configuration jobs in Silver Spring, MD are:

What cities near Silver Spring, MD are hiring for Claims Configuration jobs?

Cities near Silver Spring, MD with the most Claims Configuration job openings:

AI Engineer - Clinical AI Platform

Medisolv, Inc.

Columbia, MD • On-site

Full-time

Re-posted 14 days ago


Job description

Description:

Who We Are

Healthcare quality is complex. Medisolv helps make it manageable and actionable.

We partner with hospitals, health systems, ACOs, and payers to bring clarity to quality data, connecting clinical and claims information into a single, reliable view. More than 1,800 organizations rely on Medisolv to measure, report, and improve performance across 500+ measures tied to CMS, The Joint Commission, and other programs for 130M+ patient records.

With support from Bessemer Venture Partners Forge, we’re continuing to grow our platform and expand our impact by investing in advanced analytics, AI, and new capabilities that help healthcare organizations stay ahead of change and improve outcomes with confidence.


The Role

We are looking for an AI Engineer to help build and evolve the core application platform behind our clinical AI product. This is not a typical CRUD app role, and it is not purely a data engineering role either. You will work on the application logic, orchestration, operational tooling, and system integrations that allow our platform to process clinical documents, run graph-based AI workflows, and produce reliable outputs across multiple health systems.


You will work on software that has to reconcile messy real-world inputs, support multiple customers with different requirements, and make AI behavior operationally trustworthy. The work spans architecture, product behavior, cloud systems, LLM workflows, and internal tooling. It is highly practical, technically challenging, and directly connected to real clinical use cases.


This role is ideal for an engineer who likes owning real product behavior end to end: application architecture, workflow orchestration, reliability, developer ergonomics, cloud integrations, and the practical realities of shipping AI-powered software in healthcare.


What You'll Be Doing:

• Core application workflows: Build and maintain the runtime workflows that retrieve clinical data, execute graph-based reasoning pipelines, and write outputs back to the platform in a reliable, observable way.


• LLM-powered product logic: Improve how the application uses LLMs for document understanding, evidence generation, and structured extraction, with attention to correctness, latency, cost, and traceability.


• Configuration-driven multi-tenant architecture: Extend the platform so it can support new facilities, clinical registries, and customer-specific behavior through shared abstractions and designed configuration layers rather than ad hoc branching.


• Operational tooling and internal UX: Improve the tooling that supports configuration updates, node evaluation, issue-driven workflows, and other internal product operations so that engineers and clinical teammates can work faster and safer.


• Testing and reliability: Maintain and improve the validation, testing, and monitoring layers so changes to prompts, graph logic, or facility-specific configuration do not silently degrade output quality.


• Developer experience and maintainability: Help shape the codebase, patterns, and abstractions so the system stays understandable as we add new registries, workflows, and product surfaces.



What You’ll Accomplish - Your Performance Objectives

In your first 30 days, you will:

· You will onboard and get to know the people, products and departments that make Medisolv run.

· Complete onboarding across engineering, product, clinical, and data teams; build working relationships with key partners and understand how the Clinical AI platform supports customer outcomes.

· Get familiar with the platform architecture, core services, data flows, deployment model, and operational tooling used to run AI workflows in production.

· Set up the local development environment, access required systems, and push meaningful code changes to become productive in the codebase.

· Learn the clinical document processing and graph-based workflow lifecycle, including how inputs are retrieved, transformed, evaluated, and written back to the platform.

· Review current reliability, testing, observability, and prompt or workflow validation practices to understand how quality is maintained across customer-specific configurations.


In your first 6 months, you will:

• Own an important area of the Clinical AI platform end to end, from design and implementation through operational readiness and ongoing improvement.

• Design and ship enhancements that improve multi-tenant scalability, maintainability, and configurability across customers, facilities, and clinical registries.

• Improve internal tooling and operator workflows so engineering and clinical teammates can evaluate nodes, troubleshoot issues, and manage configuration changes more efficiently.

• Lead root-cause analysis and reliability improvements for production issues, using observability data and test results to harden the system.

• Help raise engineering quality by contributing reusable patterns, cleaner abstractions, and better developer ergonomics across the codebase.


In your first 12 months, you will:

• Be a trusted technical owner for a significant portion of the Clinical AI platform, consistently delivering reliable, maintainable, and high-impact product behavior.

• Drive architectural improvements that make the platform more scalable, observable, and resilient as new AI workflows, customers, and registries are added.

• Demonstrate measurable impact on product quality and operational trustworthiness through stronger validation, reduced incidents, improved workflow performance, or better model-driven outputs.

• Influence cross-functional roadmap decisions by bringing sound engineering judgment to product, clinical, and platform tradeoffs.

• Help shape how the team builds AI-powered software in healthcare by contributing best practices for testing, evaluation, reliability, and responsible production operations.


Who We’re Looking For - The Competencies That Matter

You are an owner. You take initiative, move work forward, and are comfortable owning problems from discovery through implementation. You have a strong bias for action and know how to make progress in ambiguous situations without losing sight of quality, reliability, or the needs of the end user.


Systems thinker and builder. You can break down complex technical problems, design practical solutions, and build with maintainability in mind. You understand how application logic, workflows, infrastructure, and internal tooling work together, and you make thoughtful design choices that support scale and long-term flexibility.


Collaborative and pragmatic. You work effectively across engineering, product, and clinical teams, balancing technical rigor with practical execution. You communicate clearly, incorporate feedback, and build strong working relationships that help move complex work forward.


Analytical problem solver. You know how to diagnose issues methodically, evaluate tradeoffs, and make sound decisions in complex systems. Whether the challenge is workflow behavior, model output quality, observability, or production reliability, you can identify root causes and turn insights into practical improvements.


Continuous improvement mindset. You look for better ways to build, test, validate, and operate software. You care about reducing friction for both users and internal teams, and you use automation, tooling, and process improvements to make the platform more reliable, scalable, and easier to maintain over time.


How to be a Medisolver – Our Values

• Customer Success Obsession

• All-Star Team Collaboration

• Continuous Improvement through Curiosity & Data-Driven Learning

• Courage with Kindness

• Execution Focus. We Do Business, Not Just Talk Business

Medisolv is committed to creating a diverse and inclusive workplace. We believe that diversity drives innovation, and we are dedicated to fostering an environment where all employees feel valued and respected.


All candidates must successfully pass a pre-employment background check and be legally authorized to work in the United States. Sponsorship is not available.

Requirements: