Facets Analyst

Benefits:

• REMOTE
• Competitive salary
• Flexible schedule
• Opportunity for advancement

Job Title: Facets Analyst – US Healthcare Payer
Experience: 5+ years
Location: Remote – United States
Work Hours: EST hours
Employment: Full-Time
Geographic Restrictions: Candidates must reside in the U.S.

We are seeking an experienced Facets Analyst with strong expertise in Facets claims processing and the US healthcare payer domain. The ideal candidate will have hands-on knowledge of Facets modules, including Claims, Accumulators (Accums), Payments, and ASO, along with strong analytical and SQL skills.

The candidate will work closely with business and technical teams to analyze healthcare claims requirements, identify system/process issues, support Facets configurations and enhancements, and ensure accurate claims processing.

Key Responsibilities

• Analyze business and system requirements related to Facets claims processing and healthcare payer operations.
• Provide functional expertise across Facets Claims, Accumulators, Payments, and ASO modules.
• Analyze claims, benefits, accumulations, payment processing, and related healthcare payer workflows.
• Investigate claims processing issues, perform root-cause analysis, and recommend solutions.
• Work with business stakeholders, developers, QA teams, and other technical teams to translate business requirements into functional specifications.
• Perform data analysis and validation using Oracle SQL/PL/SQL.
• Support production issue analysis, defect resolution, testing, and implementation activities.
• Review claims data and system outputs to identify discrepancies and ensure processing accuracy.
• Develop and execute functional test scenarios for Facets enhancements and fixes.
• Participate in requirements gathering, impact analysis, system testing, and user acceptance testing.
• Document business processes, functional requirements, issue analysis, and solution recommendations.
• Collaborate with cross-functional teams in an Agile or similar delivery environment.

Required Qualifications

• 5+ years of experience as a Facets Analyst or in a similar Facets-focused role.
• Strong hands-on knowledge of Facets Claims is mandatory.
• Experience with Facets Accumulators (Accums), Payments, and ASO.
• Strong understanding of the US healthcare payer domain and healthcare claims processing.
• Experience analyzing claims processing issues and business requirements.
• Strong Oracle SQL/PL/SQL skills for data analysis and validation.
• Excellent analytical, problem-solving, and communication skills.
• Experience working with business and technical stakeholders in a healthcare IT environment.
• Ability to work remotely while supporting EST business hours.

Preferred Qualifications

• Experience with .NET or understanding of .NET-based applications.
• Experience working in Agile/Scrum environments.
• Knowledge of healthcare EDI transactions and payer systems is a plus.
• Experience with Facets implementations, enhancements, upgrades, or production support is preferred.

Education

• Bachelor’s degree in Computer Science, Information Technology, Healthcare Informatics, Business, or a related field is preferred.

This is a remote position.