Senior Claims Configuration & Optimization Lead

Devoted Health Services, Inc; Waltham (MA); Remote; USD 58,000 - 96,000; Full time

Benefits offered by this job

Health, dental and vision plan

Generous paid time off

$100 monthly mobile stipend

Stock options for all employees

Bonus eligibility for all roles

401K program

Parental leave

And more...

Job summary

Devoted Health Services, Inc. is seeking a Claims Benefit Configuration Senior Associate to oversee all aspects of claims benefit setup, analysis, mapping, testing, troubleshooting, and implementation.

You will ensure accurate member cost share, benefit limits, and provider payment information while liaising with MedProduct, Clinical, and Claims teams. The role emphasizes data-driven analysis, QA procedures, and end-to-end readiness for benefit configuration, with remote-friendly operations and

Qualifications

• Bachelor’s degree required or equivalent professional experience
• Experience with health insurance claims processing is a plus
• Certified professional coder (CPC) is a plus
• Experience collaborating with offshore resources or distributed teams
• Experience applying AI and automation to reduce manual work

Responsibilities

• Interpret, analyze, implement and audit claims configuration including benefits and authorization
• Manage claims benefit configuration communications and responses
• Develop and enforce quality control procedures for claims configuration
• Lead annual readiness for benefit configuration and BID application management
• Oversee Denial Reasons library ensuring accurate mapping
• Identify and implement process improvements to scale configuration operations

Skills

Data analysis

Analytical thinking

Communication

Cross-functional collaboration

Prioritization

Problem solving

Education

Bachelor’s degree

Tools

Google Sheets

Excel

Job description

Devoted Health Services, Inc. is seeking a Claims Benefit Configuration Senior Associate to oversee all aspects of claims benefit setup, analysis, mapping, testing, troubleshooting, and implementation.

You will ensure accurate member cost share, benefit limits, and provider payment information while liaising with MedProduct, Clinical, and Claims teams. The role emphasizes data-driven analysis, QA procedures, and end-to-end readiness for benefit configuration, with remote-friendly operations and