Healthcare IS ยท 23 hours ago
Facets Claims Configuration Specialist
Healthcare IS is seeking an experienced Facets Claims Configuration Analyst to assist with claims setup, maintenance, and optimization within the Facets platform. This role focuses on hands-on configuration and requires close collaboration with business and technical teams.
ConsultingData IntegrationElectronic Health Record (EHR)Health CarePharmaceutical
Responsibilities
Configure, maintain, and update Facets claims processing rules and benefit configurations
Build and modify claims edits, pricing logic, and adjudication workflows
Analyze business requirements and translate them into Facets configuration solutions
Support testing efforts, including unit, integration, and UAT testing
Troubleshoot claims processing issues and recommend configuration fixes
Collaborate with business, operations, and IT teams to ensure accurate claims outcomes
Document configuration changes and follow established change-control processes
Qualification
Required
Strong hands-on experience with Facets claims configuration
Solid understanding of claims adjudication, pricing, and benefits setup
Experience working in payer or health plan environments
Ability to work independently in a contract, remote setting
Strong analytical, problem-solving, and communication skills