Overview
Remote
Depends on Experience
Accepts corp to corp applications
Contract - W2
Contract - Independent
Contract - 12 Month(s)
Skills
ACH
Acceptance Testing
Analytical Skill
Attention To Detail
Billing
Broadcasting
Collaboration
Communication
Conflict Resolution
Data Entry
Facets
HCPCS
HMO
ICD-10
ICD-9
LIS
Management
Medicaid
Medicare
Professional Development
Network
PPO
Point Of Sale
Pricing
Problem Solving
Process Improvement
Publishing
Testing
Workflow
Job Details
Facets Developer
Remote - CST Time zone
Job Description/ 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
- Exhibit excellent analytical and problem-solving skills.
- Have strong communication and collaboration abilities.
- Be detail-oriented and able to manage multiple tasks effectively.
- Display a commitment to continuous learning and professional development.
- Be able to work as part of a team.
- Show a proactive approach to identifying and addressing issues.
- Demonstrate the ability to create clear and concise reports and visualizations.
Employers have access to artificial intelligence language tools (“AI”) that help generate and enhance job descriptions and AI may have been used to create this description. The position description has been reviewed for accuracy and Dice believes it to correctly reflect the job opportunity.