Role: Benefits Configuration Analyst (Facets)
Location: Remote
Type: Fulltime
Job description:
Role & Responsibilities:
Design, analyze, and implement benefit coding change requests with a high level of precision, ensuring alignment with client specifications and regulatory requirements.
Gather, interpret, and evaluate complex client requirements to assess the impact of benefit designs on claims processing; effectively communicate tailored benefit setup options to stakeholders and internal teams, thereby advising on optimal solutions.
Manage non-standardized plan design concepts and client programs by overseeing coding, rigorous testing, and validation processes to ensure accuracy and compliance.
Lead collaborative dialogues within cross-functional teams to clarify client intent and optimize program setups, fostering alignment across project deliverables.
Serve as a key troubleshooter by coordinating resolution efforts among multiple internal and external teams; ensure timely implementation of solutions and maintain high client satisfaction.
Partner with technical and operations teams to translate client-specific requirements into detailed technical design specifications and data flow models, supporting development and coding efforts.
Experience & Qualifications:
Demonstrated knowledge of claims processing methodology with compulsory experience in working within Facets platforms.
Expertise in benefit configuration and group setup processes, enabling precise and compliant benefits administration.
Previous exposure to Healthcare Business Process Outsourcing (BPO) environments, delivering operational efficiencies and client-focused solutions.
A minimum of 3 years' professional experience in claims processing within Facets environments, showcasing strong problem-solving and technical skills.
Educational background meeting at least a high school diploma or equivalent undergraduate coursework relevant to healthcare or information systems.