Senior Claims Benefit Configuration Associate

. Oversee all aspects of claims benefit setup, analysis, mapping, testing, troubleshooting, and implementation .

Posted 9/25/2026full-timeRemote • United StatesSenior💰 $58,000 - $96,000 per yearWebsite

Key responsibilities & impact

Oversee all aspects of claims benefit setup, analysis, mapping, testing, troubleshooting, and implementation
Ensure accurate configuration of member cost share, benefit limitations, and provider payment information
Act as a liaison across departments regarding benefit and claims processing
Support interpretation, analysis, implementation, and audit of claims configuration, including benefits, authorization, denial library, CMS billing and coding guidelines, and Devoted payment policies
Manage the claims benefit configuration inbox and respond to stakeholder questions while maintaining turnaround times and response quality
Develop, implement, and enforce quality control procedures for claims configuration
Perform routine reviews to enhance configuration accuracy and performance
Lead end-to-end 1/1 annual readiness for benefit configuration and BID application management
Establish project timelines, maintain documentation, and facilitate cross-functional alignment with MedProduct, Clinical, and Claims teams
Oversee the Devoted Denial Reasons library and ensure accurate mapping of internal denial codes
Identify, design, and implement process improvements to scale configuration operations, reduce error rates, and streamline cross-team execution

What you’ll need

Proven experience analyzing data sets to generate insights and turn those insights into action
Strong analytical and problem-solving skills
Fluency in google-sheets/excel
Ability and desire to learn new tools
Experience working with data analytics team on more involved data asks
Strong organizational skills and experience managing high-impact workflows with compressed timelines
Excellent communication and collaboration skills for working with cross-functional teams
Exceptional organizational skills, adept at prioritizing tasks effectively to consistently meet deadlines
Thrives in a fast paced, metrics driven environment and is comfortable with ambiguity
Some knowledge of health insurance claims processing, regulations, and compliance requirements
Certified professional coder (CPC) is a plus
Experience collaborating with offshore resources or distributed teams, with the ability to clearly communicate priorities and task requirements without direct managerial authority
Experience applying AI and automation to reduce manual operational work
Bachelor’s degree is desired; relevant professional experience will be considered in lieu of a bachelor's degree

Comp & perks