... connecting clinical and claims information into a single, reliable view. More than 1,800 ... Configuration-driven multi-tenant architecture: Extend the platform so it can support new ...
Quick apply
... connecting clinical and claims information into a single, reliable view. More than 1,800 ... Configuration-driven multi-tenant architecture: Extend the platform so it can support new ...
Quick apply
... connecting clinical and claims information into a single, reliable view. More than 1,800 ... Configuration-driven multi-tenant architecture: Extend the platform so it can support new ...
Familiarity with claims systems, configuration processes, or policy governance. Knowledge, Skills and Abilities (KSAs) * Strong organizational and coordination skills across multiple teams and ...
Familiarity with claims systems, configuration processes, or policy governance. Knowledge, Skills and Abilities (KSAs) * Strong organizational and coordination skills across multiple teams and ...
Rockville, MD · Remote
$1.2K/wk
Participate in configuration, customization, and development of standards-based HL7, X12, and ... Analyze financial and administrative workflows including claims, remittances, eligibility, payment ...
Rockville, MD · Remote
$1.2K/wk
Participate in configuration, customization, and development of standards-based HL7, X12, and ... Analyze financial and administrative workflows including claims, remittances, eligibility, payment ...
Upper Marlboro, MD · On-site
$128K - $170K/yr
... configuration, and support of enterprise audio-visual (AV) systems across County Government ... Serves as the County's technical POC for warranty claims, advanced replacement, firmware ...
Upper Marlboro, MD · On-site
$128K - $170K/yr
... configuration, and support of enterprise audio-visual (AV) systems across County Government ... Serves as the County's technical POC for warranty claims, advanced replacement, firmware ...
Washington, DC · On-site +1
$55/hr
... Claims processing is preferred. • SAFe ® for Teams Preferred • Excellent written and verbal ... They will also execute system configuration, transformations, and data mapping. The engineer works ...
Washington, DC · On-site +1
$55/hr
... Claims processing is preferred. • SAFe ® for Teams Preferred • Excellent written and verbal ... They will also execute system configuration, transformations, and data mapping. The engineer works ...
Experience with benefit configuration and product implementation. * Familiarity with claims, enrollment, provider, and member systems. * SQL proficiency for data analysis. * Experience using Jira ...
Experience with benefit configuration and product implementation. * Familiarity with claims, enrollment, provider, and member systems. * SQL proficiency for data analysis. * Experience using Jira ...
Experience with benefit configuration and product implementation. * Familiarity with claims, enrollment, provider, and member systems. * SQL proficiency for data analysis. * Experience using Jira ...
Experience with benefit configuration and product implementation. * Familiarity with claims, enrollment, provider, and member systems. * SQL proficiency for data analysis. * Experience using Jira ...
DUTIES & RESPONSIBILITIES HEDIS Data and Integration Analyze data from claims, encounters ... Support measure configuration, system upgrades, annual HEDIS specification changes, and regression ...
DUTIES & RESPONSIBILITIES HEDIS Data and Integration Analyze data from claims, encounters ... Support measure configuration, system upgrades, annual HEDIS specification changes, and regression ...
... validate claims regarding system capabilities and monitor service delivery against contractual ... Experience in centralized cloud configuration and management, meeting scalability and flexibility ...
Quick apply
... validate claims regarding system capabilities and monitor service delivery against contractual ... Experience in centralized cloud configuration and management, meeting scalability and flexibility ...
Falls Church, VA · Remote
$114K - $141K/yr
Support the design, configuration, and sustainment of enterprise Identity Provider (IdP) services ... Help develop and maintain authentication policies, claims rules, attribute mappings, and token ...
Falls Church, VA · Remote
$114K - $141K/yr
Support the design, configuration, and sustainment of enterprise Identity Provider (IdP) services ... Help develop and maintain authentication policies, claims rules, attribute mappings, and token ...
Fort George G Meade, MD · On-site
$118K - $147K/yr
Support the design, configuration, and sustainment of enterprise Identity Provider (IdP) services ... Help develop and maintain authentication policies, claims rules, attribute mappings, and token ...
Fort George G Meade, MD · On-site
$118K - $147K/yr
Support the design, configuration, and sustainment of enterprise Identity Provider (IdP) services ... Help develop and maintain authentication policies, claims rules, attribute mappings, and token ...
Claims Adjudication, Benefits Configuration, Provider and Payment Experience Preferred * Advanced degree * Certified Agile Product Owner * SAFe Agile Product Owner Certification Knowledge, Skills and ...
Claims Adjudication, Benefits Configuration, Provider and Payment Experience Preferred * Advanced degree * Certified Agile Product Owner * SAFe Agile Product Owner Certification Knowledge, Skills and ...
Fort George G Meade, MD · On-site
$118K - $147K/yr
Support the design, configuration, and sustainment of enterprise Identity Provider (IdP) services ... Help develop and maintain authentication policies, claims rules, attribute mappings, and token ...
Fort George G Meade, MD · On-site
$118K - $147K/yr
Support the design, configuration, and sustainment of enterprise Identity Provider (IdP) services ... Help develop and maintain authentication policies, claims rules, attribute mappings, and token ...
Own the lifecycle of company-issued technology: configuration, deployment, maintenance, repair ... claims, and returns * Cellular and connected devices - Administer service plans and connected ...
Own the lifecycle of company-issued technology: configuration, deployment, maintenance, repair ... claims, and returns * Cellular and connected devices - Administer service plans and connected ...
Windsor Mill, MD · On-site
$135K - $216K/yr
Responsibilities About The Role The Defense Mission and Health Solutions team, Benefits, Claims ... Knowledge of agile development, configuration management, and integration testing practices.
Windsor Mill, MD · On-site
$135K - $216K/yr
Responsibilities About The Role The Defense Mission and Health Solutions team, Benefits, Claims ... Knowledge of agile development, configuration management, and integration testing practices.
$135K - $216K/yr
Responsibilities About The Role The Defense Mission and Health Solutions team, Benefits, Claims ... Knowledge of agile development, configuration management, and integration testing practices.
$135K - $216K/yr
Responsibilities About The Role The Defense Mission and Health Solutions team, Benefits, Claims ... Knowledge of agile development, configuration management, and integration testing practices.
Mclean, VA · On-site
... claims data, utilization trends, and vendor reporting to identify insights and support recommendations. * Support key annual initiatives including Open Enrollment, systems testing/configuration ...
Mclean, VA · On-site
... claims data, utilization trends, and vendor reporting to identify insights and support recommendations. * Support key annual initiatives including Open Enrollment, systems testing/configuration ...
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 ...
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 ...
Windsor Mill, MD · On-site
$135K - $216K/yr
Responsibilities About The Role The Defense Mission and Health Solutions team, Benefits, Claims ... Knowledge of agile development, configuration management, and integration testing practices.
Windsor Mill, MD · On-site
$135K - $216K/yr
Responsibilities About The Role The Defense Mission and Health Solutions team, Benefits, Claims ... Knowledge of agile development, configuration management, and integration testing practices.
Rosslyn, VA · On-site
$190K/yr
Knowledge of X12 (claims/EDI) for revenue cycle integrations and/or other healthcare standards (e.g ... configuration alone is insufficient. * Configure integration connectivity and protocols (as ...
Rosslyn, VA · On-site
$190K/yr
Knowledge of X12 (claims/EDI) for revenue cycle integrations and/or other healthcare standards (e.g ... configuration alone is insufficient. * Configure integration connectivity and protocols (as ...
$36.2K - $46K
4% of jobs
$46K - $55.7K
4% of jobs
$55.7K - $65.5K
10% of jobs
$69.2K is the 25th percentile. Wages below this are outliers.
$65.5K - $75.3K
18% of jobs
$75.3K - $85.1K
12% of jobs
The median wage is $86.7K / yr.
$85.1K - $94.8K
13% of jobs
$94.8K - $104.6K
14% of jobs
$105K is the 75th percentile. Wages above this are outliers.
$104.6K - $114.4K
12% of jobs
$114.4K - $124.1K
7% of jobs
$124.1K - $133.9K
4% of jobs
$133.9K - $143.7K
2% of jobs
$36.2K
$90.8K
$143.7K
| 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.
For Claims Configuration jobs in Silver Spring, MD, the most frequently searched job titles are:
The top searched job categories for Claims Configuration jobs in Silver Spring, MD are:
Cities near Silver Spring, MD with the most Claims Configuration job openings:
Full-time
Re-posted 14 days ago
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:Sourced by ZipRecruiter
Health care and social assistance
51 - 200 Employees
Columbia, MD, US
1999