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Facets Consultant 
(Job)

resume-library  |  United States  |  

Ref:
PARTNER-3Z5XS8
Direct:
Employer:
Location:
United StatesUnited States (US)
Category:
Consulting/Consulting
Work Type:
Permanent
Work Time:
Full Time
Tags:
job,united-states,resume-library

Description 

Facets Consultant

Must Have's:



Facets- Configuration



Facets-Membership



SQL Server



Claims



Skill Set /Experience Requirements:



" 3+ years of Facets Claims experience



" 3+ years of Benefits Configuration experience



" Good level of knowledge in benefits and products



" Good Understanding for Healthcare domain



" Benefits 360 experience is a plus.



Job description:



" Ability to read Benefits Grids, PBP documentation to understand Configuration Requirements.



" Experienced in participate in Design sessions with Configuration SMEs and Architects.



" Ability to load and maintain Group Class Plans, Products, Benefits, Limits, Deductibles, Service Payments, Service definitions Facets claims processing system



" Experience in Auth Configuration, Procedure Code Sets, and ICD-10 Diagnosis Code Sets for configuration.



" Experience in Supplemental Configuration, Premium Rates is needed



" Previous experience in Claims testing is required to validate Benefit configuration accuracy.



" Collaborate with benefits operations and technology teams to develop configuration solutions.



" Good Analytical skills on Databases (Oracle & SQL Server) for loading large code sets.



" Research and resolve reported issues, related to Benefits related issues.



" Knowledge of billing practices and claims coding is an add on.



Diverse Lynx LLC is an Equal Employment Opportunity employer. All qualified applicants will receive due consideration for employment without any discrimination. All applicants will be evaluated solely on the basis of their ability, competence and their proven capability to perform the functions outlined in the corresponding role. We promote and support a diverse workforce across all levels in the company.