Claims Benefit Configuration Senior Associate
Core
Oversees claims benefit setup, analysis, mapping, testing, and implementation to ensure accurate member cost share, benefit limitations, and provider payment information.
Role type
Senior Associate, Claims Benefit Configuration
Builds
Claims payment logic, benefit configurations, and denial reason mappings
Domain
Health Insurance / Claims Operations
Deliverable
production ML models | product features | dashboards & analysis | client delivery
Required skills
Data analysis, Google Sheets/Excel fluency, workflow management, cross-functional communication, prioritization, process improvement
Preferred skills
Health insurance claims processing knowledge, CPC certification, AI/automation application, offshore team collaboration
Technologies
Google Sheets, Excel, Devoted proprietary platform
Responsibilities
Interpret and analyze claims data for benefits and authorizations; manage configuration inbox for stakeholder queries; develop quality control procedures; lead annual readiness and BID application management; oversee Devoted Denial Reasons library mapping; design process improvements to reduce error rates.
Seniority
Senior, hands-on IC