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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.

Reference : Healthcare Data Analyst (Claims Admin, Facets) PAYS $46/HR Mason, OH jobs

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Published at 12-07-2025
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