Hiring: Senior Configuration Quality Audit Analyst Company: Personify Health Location: Tempe, AZ Job Posted Time: 2026-09-10 11:36:26 Target Skills & Keywords : HIPAA, Quality Assurance, REST About the job Experience: •3+ years of progressive experience in claims configuration, claims auditing, quality assurance, benefits administration, or related healthcare operations Required Skills: •Ready to make sure every claim gets it right? •Lead configuration audits: Own the end-to-end audit and validation of complex claims system configurations, confirming accuracy against client requirements, provider contracts, benefit plans, fee schedules, and regulatory guidelines. •Translate plan language into system logic: Interpret Summary Plan Descriptions (SPDs), client-specific requirements, and contractual agreements, converting them into precise system rules, benefit matrices, and cost-sharing structures. •Validate configuration changes: Review updates to member enrollment, provider contracts, plan design, claims processing guidelines, and system enhancements before they go live. •Analyze claims for accuracy: Dig into complex institutional and professional claims to verify configuration, adjudication logic, and processing outcomes are working as intended. •Resolve configuration issues at the root: Research and troubleshoot claim adjudication and configuration problems, tracing them to root cause and recommending fixes that stick. •Build test strategies: Develop test cases and audit methodologies that support system enhancements, configuration updates, and process improvements. •Improve auto-adjudication rates: Evaluate automated configuration solutions and identify opportunities to boost accuracy, efficiency, and straight-through processing. Qualifications: •Bachelor's degree in Healthcare Administration, Business, Information Systems, or a related field, or an equivalent combination of education and experience Compensation: •$70,000 - $83,000 / year •Comprehensive medical and dental through our own health solutions (yes, we use what we build) Interested candidates, please apply directly through the job posting on company's career page or try via AI auto apply on this platform. Don't miss this opportunity to join a forward-thinking team!