
Claims Configuration Dev
4 days ago
**Job Information**:
Date Opened
- 06/23/2025
Job Type
- Full time
Industry
- IT Services
Remote Job
This is a remote position.
**Key Responsibilities**:
- Analyze business and regulatory requirements to configure claims systems (e.g., Facets, QNXT, HealthEdge, Amisys, etc.).
- Design and implement claims processing logic, benefits, pricing, editing rules, accumulators, and provider reimbursement logic.
- Collaborate with business analysts, QA testers, and claims operations to validate configurations.
- Perform unit testing and support QA in end-to-end testing of claims scenarios.
- Troubleshoot and resolve issues related to claims configuration or processing errors.
- Participate in configuration audits and peer reviews to ensure accuracy and compliance.
- Maintain documentation for all configuration changes and system logic.
- Support production issues and provide timely resolution for escalated claim exceptions.
- Stay up to date with changes in healthcare regulations, payer requirements, and system upgrades.
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