In this position, you would be responsible for defining and configuring various aspects in Facets required to accurately administer benefit and provider pricing.
- Analyze products, contracts and pricing, design / configure claim rules and clinical rules, conduct configuration validation, and perform configuration peer review
- Evaluate business requirements and determine global design
- High School Diploma / GED or higher
- Ability to work Monday - Friday 8am - 5pm
- Institutional and Professional Claims processing experience
- 1+ years of system configuration experience OR facets Claims experience at a health plan or delegated entity
- 3+ years of facets configuration experience
- Coding experience in one or more of the following: CPT, HCPCS, ICD9 / ICD10, Revenue, DRG or other relevant medical and industry-standard codes
- Knowledge of supporting tools from Trizetto and other vendors such as CMU, EncodePro etc.
- Knowledge of Medicare Pricing
Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity / Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
Keywords: facets, analyze, process, claims, configuration, coding, medicare