Healthcare IT Configuration Analyst — Claims & Compliance

Independent Living Systems, llc; Miami (FL); On-site; USD 65,000 - 95,000; Full time

Job summary

Independent Living Systems, llc is seeking a Configuration Analyst in Miami, FL to ensure healthcare software configurations meet regulatory and operational needs. The role emphasizes analyzing system configurations, testing changes, and collaborating with clinical, administrative, and IT teams to support member care workflows and compliance.

The ideal candidate has knowledge of UB04/CMS1500, ICD-10 coding, claim adjudication, EDI/OCR submission, and Medicare/Medicaid reimbursement methods, with

Qualifications

• High School diploma or GED required.
• Minimum two (2) years' experience in medical claims-related roles.
• Knowledge of UB04 / CMS1500 claims, ICD-10 / CPT / HCPCS coding, claim adjudication processes, EDI and OCR claim submission.
• Proven ability to analyze data and summarize in an organized and professional manner.
• Ability to read and interpret contracts and other related documents required.
• Proficient in Microsoft Office (Word, Excel, PowerPoint, and Access) required.
• Relevant education may substitute for educational requirement on a year-for-year basis.

Responsibilities

• Claims testing and processing including claim adjustments, as well as providing support and education to the staff as necessary.
• The incumbent will troubleshoot and resolve provider records to support the claims operation.
• Process claims in accordance with corporate policies and procedures and state regulations.
• Review and analyze a variety of claim samples including auto-adjudicated claims to assure pricing per contractual agreement, negotiated rate or to Medicaid and Medicare rates.
• Provide consistent feedback to Management in timely manner both individually and collectively.
• Participate in ad-hoc projects as necessary.

Skills

2+ years experience in medical claims

UB04 CMS1500 knowledge

ICD-10 CPT HCPCS coding

Claim adjudication processes

EDI & OCR submission

Medicare/Medicaid reimbursement

Data analysis & summarization

Contract interpretation

MS Office proficiency

Education

High School diploma or GED

Associate's degree in health care or related field

Tools

Healthcare analytics tools

Project management basics

Job description

Independent Living Systems, llc is seeking a Configuration Analyst in Miami, FL to ensure healthcare software configurations meet regulatory and operational needs. The role emphasizes analyzing system configurations, testing changes, and collaborating with clinical, administrative, and IT teams to support member care workflows and compliance.

The ideal candidate has knowledge of UB04/CMS1500, ICD-10 coding, claim adjudication, EDI/OCR submission, and Medicare/Medicaid reimbursement methods, with