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

VTRQYitid0EzY0NyT3Q1YXZUQk5adG4yaVE9PQ==
  • 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,

Similar Jobs

BWXT

Manufacturing Engineering Intern Job at BWXT

 ...Defense News Top 100 manufacturing and engineering innovator that provides safe and effective...  ...fuel for the commercial nuclear power industry across four continents. Our joint...  ...If you are looking for a Summer 2026 internship opportunity where innovative thinking is... 

Taylor Grubaugh Chevrolet - Waynesville

Parts Manager Job at Taylor Grubaugh Chevrolet - Waynesville

PARTS MANAGER at TAYLOR GRUBAUGH CHEVROLET of Waynesville Taylor Grubaugh Chevrolet of Waynesville is a leading General Motors dealership dedicated to delivering exceptional customer service and providing genuine GM parts and accessories. We are seeking a... 

mylife2liveinc

Medical Billing and Coding Specialist Paid Internship Program Job at mylife2liveinc

 ...field and there is always moreneed than certified specialists! Healthcare is one of thefew recession-proof career fields, so you...  ...soon as you obtain your certification! All of ourpositions are entry-level positions, so you do not need adegree to become certified!... 

APT Electronics, Inc.

Quality Engineer - RMA Job at APT Electronics, Inc.

 ...Quality Management or equivalent experience. # Minimum (5) five years experience directly related to electronics assembly including SMT, Through Hole, Box Build and Hand soldering. # Knowledge of the International Standards ISO 9000, AS9100 and ISO 13485. #... 

EY

Service delivery center data machine learning engineer - analyst Job at EY

 ...want it to go. Join EY and help to build a better working world. Analyst - Financial Services Organization - AI and Data - Service Delivery Center EY is the only professional services firm with a separate business unit ("FSO") that is dedicated to the financial...