Senior Facets Configuration Analyst

Responsibilities:

• Configure Facets components for healthcare claims processing needs, encompassing benefits, pricing, and rules
• Validate Facets configuration to ensure it meets expected claims adjudication outcomes and parity results
• Collaborate with System Integration and EDI teams to align Facets configuration with incoming HIPAA transactions (837) and anticipated remittance outputs (835)
• Investigate and troubleshoot configuration-related issues affecting claims adjudication, testing, and parity validation
• Assist in testing and validation cycles by reviewing comprehensive claim scenarios and their results
• Document configuration strategies, decisions, dependencies, and assumptions to support Proof of Concept deliverables and downstream teams

Requirements:

Must have:

• Proven experience in configuring Facets, including benefits, pricing, and claims setup
• In-depth knowledge of healthcare claims adjudication procedures
• Previous work experience with healthcare payers is essential
• Strong capability to analyze claim situations and compare expected versus actual results
• Experience in supporting system testing, validation, and defect resolution processes

Company:

We are looking for a Senior Facets Configuration & Integration Analyst to join our System Integration team. This remote position offers the opportunity to work on impactful healthcare projects, specifically focusing on the configuration and validation of the Facets core claims platform. We prioritize flexibility and promote a healthy work-life balance through well-being programs. Our commitment to collaboration fosters an environment where diverse backgrounds contribute to innovative solutions. We offer a competitive salary range of $113K-$132K, along with various benefits, including medical, dental, and vision insurance, paid time off, a 401(k) plan, and more. Join us if you thrive in a dynamic, collaborative atmosphere!