Location: 2-Woodland Hills, CA/4-Mason, Ohio (Onsite)
Job Description: Please refer the attached JD as well.
1 – A technical system analyst with good understanding of the healthcare process flow – Eligibility & Enrollment – Provider contract pricing – Claims adjudication – Billing – Appeals and Grievances
2 – Technical understanding of Sql and Dot net – full stack preferable
3 – knowledge of Facets platform from a developer point of view – i.e. data models, architecture, and process flow
4 – Good experience in working with Business and technical teams to prepare system requirements and Technical and functional documents.
5- We should focus on finding ones with hands-on Facets systems analyst experience, including with deep benefits + claims knowledge, strong data troubleshooting ability, and clear ownership of real production issues.
Digital 10X Systems Analyst JD:
Must Have
· Deep expertise in healthcare payer processes: Enrollment, Eligibility, Benefits, Claims Adjudication, Billing, Provider Management
· Strong SQL proficiency:
o Complex queries, joins, stored procedures
o Ability to analyze data across multiple systems/sources
· Solid understanding of database design, schemas, and data relationships
· Proven ability to analyze, reconcile, and troubleshoot payer data (claims, membership, benefits)
· Functional understanding of Facets platform:
o Architecture, modules, and capabilities
o How Facets supports core payer workflows
· Working knowledge of AI/ML concepts and how they apply to healthcare data (e.g., predictive analytics, automation, insights)
· Ability to translate business requirements into functional designs and data mappings
· Experience across Commercial, Medicare, and/or Medicaid lines of business
· Strong collaboration skills across business, data, and engineering teams
Nice to Have
· Experience with Facets configuration or development
· Background in Java (Spring Boot / microservices)
· Familiarity with React UI applications and front-end workflows
· Understanding of API-based integrations and data flow between systems
· Hands-on experience in AI/ML projects (e.g., claims analytics, fraud detection, member insights, automation use cases)
· Exposure to Azure and AWS cloud platforms
· Knowledge of healthcare EDI transactions (834, 835, 837)
· Experience in data warehousing / data lake environments
Never miss an opportunity! Create an alert based on the job you applied for.
