Top 12 Senior configuration quality audit analyst Jobs in Phoenix Az

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Senior Configuration Quality Audit Analyst

Personify Health -
Tempe, AZ

Apply Now

Job Details

Full-time
$70,000 - $83,000 a year

Benefits

Health insurance
Dental insurance
Paid time off
Benefits from day one

Qualifications

Quality control corrective actions
Benefits administration
Data integrity assurance
Operational analysis
Defect resolution root cause analysis
Managed care
Audit report preparation
Data validation techniques
Managed care organization experience
Test Case Documentation (Quality assurance practices)
Healthcare Administration
Regulatory compliance in claims processing
Bachelor's degree in business
HIPAA
Healthcare documentation compliance audits
Information Systems
3 years
Quality control audit
Quality reports
Medical claims processing software
Data integrity and documentation
Analysis skills
Presentation skills
Bachelor's degree
Health insurance knowledge
Continuous improvement
Health information data integrity
System validation
Risk analysis
Mentoring

Full Job Description

Overview:

Who We Are

Because health is personal. That's why Personify Health created the first and only personalized health platform—bringing health plan administration, holistic wellbeing solutions, and comprehensive care navigation together in one place. We serve employers, health plans, and health systems with data-driven solutions that reduce costs while actually improving health outcomes. Together, our team is on a mission to empower people to lead healthier lives.

Learn even more about the work that drives us at personifyhealth.com.

Responsibilities:

Ready to make sure every claim gets it right?

Why This Role Matters

Every claim that runs through our system tells a real story — a member getting the care they need, a provider getting paid correctly, a client trusting that their plan is doing what it's supposed to do. This role is the safeguard behind that trust: catching configuration errors before they become member complaints, compliance gaps, or costly rework. When benefit plans, fee schedules, and adjudication rules are set up right, claims process faster, auto-adjudication rates climb, and clients stop worrying and start relying on us. The audits and root-cause fixes this person drives don't just clean up today's errors — they prevent tomorrow's. Get this right, and the whole claims operation runs smoother, faster, and more accurately, directly moving the needle on the outcomes clients and members actually feel.

What You'll Actually Do

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.
Report on quality and risk: Prepare and maintain audit results, quality metrics, and ad hoc reports that give leadership what they need to make informed decisions.
Share findings that drive change: Communicate audit findings, trends, risks, and recommendations to internal stakeholders and leadership in a way that leads to action.
Set the standard for audit quality: Provide subject matter expertise and mentoring to peers, helping shape audit standards, quality controls, and best practices across the team.
Support compliance and process initiatives: Participate in cross-functional efforts focused on compliance, operational excellence, and system optimization.
Uphold regulatory and data standards: Ensure ongoing adherence to HIPAA, claim processing requirements, and data integrity controls.

Qualifications:

What You Bring to Our Team

Education & Experience:

Bachelor's degree in Healthcare Administration, Business, Information Systems, or a related field, or an equivalent combination of education and experience
3+ years of progressive experience in claims configuration, claims auditing, quality assurance, benefits administration, or related healthcare operations
Experience in self-funded health plans, third-party administration (TPA), healthcare payer operations, or managed care environments preferred

Technical Skills:

Advanced experience working within the Javelina claims processing platform or similar core claims administration systems
Experience interpreting Summary Plan Descriptions (SPDs), provider contracts, and benefit plan designs
Demonstrated experience performing complex claims analysis, system testing, auditing, and root cause investigation

The professional qualities:

Flexibility to meet changing business requirements with strong commitment to high-quality, on-time delivery
Excellent communication skills for presenting audit findings to diverse stakeholders
Problem-solving mindset with ability to recommend solutions that improve auto-adjudication efficiency
Collaborative approach to working with cross-functional teams on system updates and configuration changes

Benefits

The Highlights:

Competitive base salary and benefits effective day one
Comprehensive medical and dental through our own health solutions (yes, we use what we build)
Paid Time Off—rest and recharge time is non-negotiable
Mental health support, retirement planning, and financial protection
Professional development with clear career progression and learning budgets
Mission-driven culture where diverse perspectives drive real impact on people's health

Want the full picture? Visit personifyhealthbenefits.com to explore our complete benefits package, wellness programs, and other employee perks.

Compensation: This position offers a base salary range of $70,000-$83,000 annually, depending on location, skills, and experience. You're eligible for our full benefits package starting day one.

Our Commitment: Personify Health is an equal opportunity employer committed to diversity, equity, inclusion, and belonging. We cultivate a work environment where differences are celebrated, and employees of all backgrounds are empowered to thrive—because diversity is core to who we are and critical to our work in health and wellbeing.

Stay Safe: Personify Health will never ask for payment or sensitive personal information like social security numbers during hiring. All official communication comes from verified company email addresses and or our secure applicant tracking system. Suspicious requests? Report them to [email protected]. View all legitimate openings at personifyhealth.com/careers.

Apply Now

Refine Your Search

senior configuration quality audit analyst jobs in phoenix az

Senior Configuration Quality Audit Analyst

Principal Configuration Analyst

BUSINESS ANALYST SENIOR

Sr Analyst HRIS

Senior Manager, Revenue Operations

Senior Employment Tax and Payroll Analyst

AI Technical Lead / Senior Engineer - Regrello

Clinical Data AMS Sr. Consultant

Sr Analyst, Data Platform Engineering

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