Claims Configuration, Director

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Phoenix, AZ
Job Type
Direct Hire
Apr 01, 2019
Job ID

Seeking expert in Claims Configuration to Direct and oversee the claims configuration and pricing/benefits set up within the claims payment system ensuring accurate reflection of provider contracts and claims payments with large healthcare enterprise.

  • Ensures timely and accurate configurations and pricing/benefits set up for new business implementations
  • Ensure changes in provider contracts are reflected in the claims payment system
  • Collaborate with stakeholders to gather business requirements for system configurations and set up
  • Identify and implement opportunities to automate processes to increase effectiveness and efficiency 

  • Oversee the evaluation and analysis of upcoming implementations and ensure successful and smooth transition into claims systems and processes




Bachelor's degree in Business Administration, Health Care Administration, Information Technology or related field or equivalent experience.

7+ years of configuration, claims adjudication, pricing/benefits setup, or contracting experience.