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Curative

Senior Claims Systems Analyst – AI-Enabled

Curative

. Troubleshoot claims adjudication, pricing, benefits, configuration and payment issues to identify root causes.

Posted 10/27/2026full-timeRemote • Texas • United StatesSenior💰 $110,000 - $165,000 per yearWebsite

Core Competencies

Role fit
Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in claims adjudication, pricing, and reimbursement within the healthcare payer sector, utilizing SQL and AI coding tools to troubleshoot and enhance claims processing accuracy. Proficient in collaborating with cross-functional teams to automate workflows and improve operational efficiency.

Highest-signal resume keywords
Healthcare Payer ExperienceSQL ProficiencyAI Coding Tools ExperienceClaims Configuration ValidationGit and Python Knowledge

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills
Claims AdjudicationPricingReimbursementSQLAI ToolsClaims ConfigurationData AnalyticsTestingWorkflow AutomationAudit Tracking
Soft Skills
Independent Problem-SolvingClear Communication
Tools & Technologies
Claude CodeCodexGitGoogle WorkspaceSnowflakeStreamlitHealthRules PayerFacetsTrizettoProprietary Systems
Certifications & Qualifications
ICD-10CM CertificationMS-DRG CertificationAP-DRG CertificationAPR-DRG Certification
Industry Keywords
Claims AdjudicationHealthcare PayerReimbursement MethodologiesClaims Configuration ValidationHigh-Growth Environment

Tech Stack

Tools & technologies
PythonSnowflakeSQL

About the role

Key responsibilities & impact
  • Troubleshoot claims adjudication, pricing, benefits, configuration and payment issues to identify root causes.
  • Use SQL and system data to identify affected claims, quantify financial exposure and validate findings.
  • Use Claude Code, Codex and similar AI tools to investigate code, develop fixes, write tests and create Git pull requests for engineering review.
  • Reproduce defects, test proposed corrections and verify accurate claims outcomes.
  • Partner with Claims Operations and Engineering to eliminate recurring issues, automate workflows and improve accuracy.
  • Support automated controls, advanced editing/AI solutions and workflow enhancements to improve payment accuracy and reduce administrative costs.
  • Contribute to audit tools, policies and procedures.
  • Validate claims configuration, reimbursement methodologies and processing logic.

Requirements

What you’ll need
  • 5+ years of hands-on healthcare payer experience, including claims adjudication, pricing, benefits and reimbursement.
  • Production claims-platform configuration or troubleshooting experience (e.g., HealthRules Payer, Facets, Trizetto, or proprietary systems).
  • Strong SQL skills; ability to trace issues across data, configuration and application logic.
  • Practical experience using AI coding tools such as Claude Code, Codex or equivalents to create or modify code.
  • Working knowledge of Git, PRs, testing and Python or comparable scripting.
  • Proficiency in Google Workspace and experience with audit tracking systems and data analytics tools (Snowflake, Streamlit, Claude).
  • Independent problem-solving and clear communication with claims stakeholders and software engineers.
  • BA/BS degree in a related field.
  • Certification / substantial experience working with ICD-10CM, MS-DRG, AP-DRG, and APR-DRG coding standards.
  • Experience with claims configuration validation.
  • Experience working in a high-growth environment.

Benefits

Comp & perks
  • Curative Health Plan (100% employer-covered medical premiums for you and 50% coverage for dependents on the base plan.)
  • $0 copays and $0 deductibles (with completion of our Baseline Visit)
  • Preventive and primary care built in
  • Mental health support
  • One-on-one care navigation
  • Chronic condition programs (diabetes, weight, hypertension)
  • Maternity and family planning support
  • 24/7/365 Curative Telehealth
  • Pharmacy benefits
  • Comprehensive dental and vision coverage
  • Employer-provided life and disability coverage with additional supplemental options
  • Flexible spending accounts
  • Generous PTO policy plus 11 paid annual company holidays
  • 401K for full-time employees
  • Generous Up to 8–12 weeks paid parental leave, based on role eligibility.