Benefits Configuration Analyst- Facets

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.