Claims Configuration Analyst - Stone Mountain Georgia

Company: VirtualVocations
Location: Stone Mountain, Georgia
Posted On: 02/05/2025

A company is looking for a Claims Configuration Analyst - Remote.



Key Responsibilities:

Assist in evaluating and configuring claims business rules and system functionality
Analyze coverage documents to determine configurations for member benefits and claims processing
Collaborate with departments to gather requirements and provide feedback on claims configuration changes


Required Qualifications:

Proficiency in medical terminology and coding (CPT4, ICD9, ICD10, HCPCS)
Previous experience in managed care or health plan operations related to claims configuration
Experience with analysis tools such as SQL, SAS, or Tableau
Hands-on experience with rules-based claims processing systems
High school diploma or GED from an accredited institution More...

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