Healthcare Data Analyst (Claims Admin, Facets) Job at Global Channel Management, Inc., Mason, OH

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  • Global Channel Management, Inc.
  • Mason, OH

Job Description

Healthcare Data Analyst (Claims Admin, Facets) needs Facets, 5 years of experience working within a core claims administration system.
Healthcare Data Analyst (Claims Admin, Facets) requires:
-Good analytical and problem-solving skills
-A minimum of 2 years' experience writing SQL queries and exporting data from database tables.
- Ability to manage multiple complex assignments at once
-3+ years' experience in Operations in the Healthcare industry
-Experience understanding claim adjudication for member and provider reimbursements.
-Experience with Facets platform using Claims, Provider, Network, Product Benefit Configuration
- Knowledge of Medicare and Medicaid programs
- SQL and Database experience
Healthcare Data Analyst (Claims Admin, Facets) duties:
-Write SQL queries to extract data from the database, analysis of configuration data to identify clean-up activities.
-Ensure agreement configuration accuracy that may impact provider payment and member responsibility.
-Set up new Network and Agreement configurations into the Facets system.
- Validate agreement and network configuration utilizing claims testing, SQL queries and Excel to ensure the configuration properly adjudicates during claims processing, for member benefit, reimbursements and provider pay amounts.
-Perform and resolve network and agreement configuration questions/issues sent to the Business Configuration team without guidance.
-Support the management team with on-going training activities, misc. projects, resolving issues, and serving as a subject matter expert for all Configuration requests.
Employment Type: Full-Time
Salary: $ 46.00 Per Hour

Job Tags

Hourly pay, Full time,

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