Healthcare System Analyst, Facets & Payer Systems
Overview
Own the analysis and enhancement of enterprise payer systems at PRIMUS Global Services Inc., supporting claims adjudication for a 5+ years legacy Facets environment. You will bridge business needs and technical teams, driving improvements across eligibility, billing, and appeals. This onsite contract role in Los Angeles, CA requires deep Facets and SQL expertise to diagnose and resolve complex system issues. You'll shape system changes that directly impact revenue integrity and member satisfaction.
What You'll Do8
- 1Analyze and document business requirements for Facets modules, including Eligibility & Enrollment, Claims Adjudication, and Billing.
- 2Lead root cause analysis on production issues, coordinating with developers to implement fixes using SQL and .NET.
- 3Configure and test Facets workflows, ensuring compliance with payer policies and regulatory standards.
- 4Design and execute data queries to validate claim pricing, Provider Contract Pricing, and Appeals & Grievances processes.
- 5Collaborate with payers, IT teams, and business stakeholders to define system enhancement specifications.
- 6Drive UAT cycles, tracking defects and coordinating with QA to ensure high-quality releases.
- 7Optimize Facets batch processes, reducing processing time and error rates.
- 8Document system changes and provide training to support teams on new Facets functionality.
Requirements7
- 15+ years as a Healthcare System Analyst specializing in Payer Systems.
- 2Deep hands-on experience with Facets, including Claims Adjudication and Eligibility & Enrollment.
- 3Strong SQL skills, writing complex queries for data analysis and validation.
- 4Proven ability to analyze Provider Contract Pricing and Billing workflows.
- 5Familiarity with .NET for troubleshooting and system integration support.
- 6Experience with Medicare or Medicaid claims processing.
- 7Bachelor's degree in Computer Science, Healthcare Informatics, or related field.
Salary Insight
$50 - $55k per year
Location
Required Skills
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