Facets Developer

Company: iTech US, Inc.

Job Title: Facets Developer

Location : Richardson - TX (Remote - CST preference)

Job Responsibilities :

• Oversee the integration of data with Facets systems to ensure seamless workflow and system functionality.
• Provide expertise in Facets Benefit Configuration to optimize benefit structures and improve overall efficiency.
• Substantial intelligence of Facets system applications and understanding in multiple product lines (HMO, POS, PPO, Dental, Indemnity, Medicare and Medicaid).
• Understanding of Provider tables, i.e.; Practitioner, Facility Agreements, Network and Out of Network tables.
• Analysis, configuration, data entry, testing for all FACETS subsystems.
• Build/update new Agreements, Ratesheets in NetworX Pricer/Modeler as per provider contract.
• Create new professional Agreements in NetworX as per Provider Contract.
• Configuring, identifying, and applying correct Qualifier groups, Fee Schedules to ratesheets.
• Updating NetworX qualifier groups with new codes published.
• Publishing and Broadcasting ratesheet/Qualifier group from NetworX Dev/UAT to Prod environment
• Export/Import Fee Schedule, Ratesheet from UAT to Prod environment in Pricer.
• Leading the process improvement initiative (Claims Adjudication and Pricing, Enrollment, Benefit, Billing etc)
• Expertise in coding methodologies and guidelines (i.e. CPT, HCPCS, ICD-9/ICD-10).
• Configure Billing within Facets for (Manual Check, ACH, Adjustment, Payment Write off, Deposit.etc).
• Configure Enrollment within Facets for (LIS, COB, Member, Reinstatement, Letter, Cancellation etc).
• Deep Facets functional and development knowledge, knowledge of Facets surrounding products including NetworX Pricer
• Facets Configuration experience especially CLAIMS and Provider

Required Skills :

• Have extensive experience with Facets Workflow and System Integration.
• Demonstrate expertise in Facets Benefit Configuration and Benefits.
• Show proficiency in geospatial database management and data integrity.
• Exhibit strong collaboration skills with cross-functional teams.
• Have experience in conducting audits and quality checks on geospatial data.
• Utilize advanced geospatial analysis techniques effectively.
• Support the development of geospatial data models and workflows.
• Provide training on geospatial analysis tools and techniques.
• Ensure compliance with industry standards and regulations.

Required Education : At least a Bachelor s Degree (or equivalent experience) in Computer Science, Software/Electronics Engineering, Information Systems or closely related field is required.

Necessary Skills : NetworX, Facets, Workflow, Integration, Claims, provider, Pricer/Modeler, Benefit Configuration

To Apply :

Varsha Tarange

iTech US, Inc.