Senior AI-Driven Claims Systems Analyst

Curative HR LLC; Austin (TX); On-site; USD 130,000 - 170,000; Full time

Benefits offered by this job

100% employer-covered medical premiums

Baseline Visit with $0 copays/deduct./

Maternity and family planning support

Flexible spending accounts

Generous PTO

11 paid company holidays

401K

Parental leave 8–12 weeks

Job summary

Curative is transforming health insurance by removing barriers to care. We’re seeking a technically skilled healthcare claims expert who can investigate complex claims processing issues and turn findings into actionable fixes.

You will collaborate across Claims Operations and Engineering to diagnose problems and ship engineering-ready PRs that improve our core claims platform. You’ll apply SQL, AI-assisted coding tools like Claude Code and Codex, and thoughtful testing to validate improvements

Qualifications

• 5+ years of hands-on healthcare payer experience, including claims adjudication, pricing and benefits.
• Production claims-platform configuration or troubleshooting experience with payer systems.
• Strong SQL skills and ability to trace issues across data, configuration and application logic.
• Practical experience using AI coding tools to create or modify code ( Claude Code, Codex ).
• Working knowledge of Git, PRs, testing and Python or similar scripting.
• Experience with analytics tools (Snowflake, Streamlit) and audit tracking systems.

Responsibilities

• Investigate: Troubleshoot claims adjudication, pricing, benefits, configuration and payment issues to identify root causes.
• Analyze: Use SQL and system data to identify affected claims, quantify financial exposure and validate findings.
• Build: Use Claude Code, Codex and AI tools to investigate code, develop fixes, write tests and create PRs for engineering review.
• Validate: Reproduce defects, test proposed corrections and verify accurate claims outcomes.
• Improve: Collaborate with Claims Operations and Engineering to reduce recurring issues, automate workflows and enhance accuracy.
• Champion: Ensure operational excellence by validating claims configuration, reimbursement methodologies and processing logic.

Skills

Payer experience

Claims adjudication

Pricing & benefits

SQL

Python

AI coding tools

Claude Code

Codex

Git & PRs

Testing

Google Workspace

Snowflake

Streamlit

Analytics

Communication

Problem-solving

Education

BA/BS degree

ICD-10CM / MS-DRG / APR-DRG coding standards

Tools

HealthRules Payer

Facets

Trizetto

Job description

Curative is transforming health insurance by removing barriers to care. We’re seeking a technically skilled healthcare claims expert who can investigate complex claims processing issues and turn findings into actionable fixes.

You will collaborate across Claims Operations and Engineering to diagnose problems and ship engineering-ready PRs that improve our core claims platform. You’ll apply SQL, AI-assisted coding tools like Claude Code and Codex, and thoughtful testing to validate improvements