Facets Developer

Job Title: Facets Developer

Remote - CST preference

Experience: 10+ Years

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..