Facets Claims Processors - COB - ITS Home Host

Hsmconsulting; Chicago (IL); À distance; USD 41 000 - 48 000; Plein temps

Résumé du poste

Huron Consulting Group is seeking a Project Consultant for a W2 hourly contract in the United States. The role focuses on manually reviewing and processing healthcare claims within the Facets system, including COB or ITS Home/Host scenarios.

You will interpret benefits, ensure accuracy, and resolve discrepancies to support client outcomes. Qualified candidates will have hands-on Facets experience, strong attention to detail, and clear communication.

Qualifications

• Must have current hands-on experience as a Facets Claims Examiner with advanced working knowledge of Facets claims processing
• Demonstrated experience manually processing healthcare claims, including complex/exception-based scenarios
• Current experience manually processing either Coordination of Benefits (COB) or ITS Home/Host claims
• Ability to analyze claim details, benefit information and supporting documentation to make accurate processing decisions
• Strong attention to detail, critical-thinking, and commitment to quality
• Ability to work effectively in a production-oriented, deadline-driven environment
• Clear written and verbal communication skills

Responsabilités

• Manually review, evaluate, and process healthcare claims within the Facets platform.
• Research and resolve complex claim scenarios requiring interpretation of benefits, plan provisions, payment rules, and supporting documentation.
• Process claims involving Coordination of Benefits (COB) and/or ITS Home/Host, including validation of primary and secondary payer responsibility.
• Identify claim discrepancies, determine appropriate resolution, and document claim-processing decisions accurately.
• Apply established policies, procedures, and client-specific requirements while meeting quality and productivity expectations.
• Escalate claims issues, system concerns, or processing trends when additional review is required.
• Collaborate with team members and client stakeholders to support timely and accurate claim resolution.

Connaissances

Attention to detail

Critical thinking

Clear communication

Outils

Facets

Description du poste

The Opportunity

At Huron, we're redefining what a consulting organization can be. We go beyond advice to deliver results that last. We inherit our client's challenges as if they were our own. We help them transform for the future. We advocate. We make a difference. And we intelligently, passionately, relentlessly do great work...together.

Are you the kind of person who stands ready to jump in, roll up your sleeves and transform ideas into action? Then come discover Huron.

Whether you have years of experience or come right out of college, we invite you to explore our many opportunities. Find out how you can use your talents and develop your skills to make an impact immediately. Learn about how our culture and values provide you with the kind of environment that invites new ideas and innovation. Come see how we collaborate with each other in a culture of learning, coaching, diversity and inclusion. And hear about our unwavering commitment to make a difference in partnership with our clients, shareholders, communities and colleagues.

Huron Consulting Group offers a competitive compensation and benefits package including medical, dental, and vision coverage to employees and dependents; a 401(k) plan with a generous employer match; an employee stock purchase plan; a generous Paid Time Off policy; and paid parental leave and adoption assistance. Our Wellness Program supports employee total well-being by providing free annual health screenings and coaching, bank at work, and on-site workshops, as well as ongoing programs recognizing major events in the lives of our employees throughout the year. All benefits and programs are subject to applicable eligibility requirements.

Huron is fully committed to providing equal employment opportunity to job applicants and employees in recruitment, hiring, employment, compensation, benefits, promotions, transfers, training, and all other terms and conditions of employment. Huron will not discriminate on the basis of age, race, color, gender, marital status, sexual orientation, gender identity, pregnancy, national origin, religion, veteran status, physical or mental disability, genetic information, creed, citizenship or any other status protected by laws or regulations in the locations where we do business. We endeavor to maintain a drug-free workplace.

Position Summary

Huron is a global consultancy that collaborates with clients to drive strategic growth, ignite innovation and navigate constant change. Through a combination of strategy, expertise and creativity, we help clients accelerate operational, digital and cultural transformation, enabling the change they need to own their future.

Qualifications

Key Responsibilities

• Manually review, evaluate, and process healthcare claims within the Facets platform.
• Research and resolve complex claim scenarios requiring interpretation of benefits, plan provisions, payment rules, and supporting documentation.
• Process claims involving Coordination of Benefits (COB) and/or ITS Home/Host, including validation of primary and secondary payer responsibility.
• Identify claim discrepancies, determine appropriate resolution, and document claim-processing decisions accurately.
• Apply established policies, procedures, and client-specific requirements while meeting quality and productivity expectations.
• Escalate claims issues, system concerns, or processing trends when additional review is required.
• Collaborate with team members and client stakeholders to support timely and accurate claim resolution.

Required Qualifications

• Must have current and hands-on experience as a Facets Claims Examiner, with advanced working knowledge of Facets claims processing (not Configuration).
• Demonstrated experience manually processing healthcare claims, including complex and exception-based scenarios.
• Current experience manually processing either Coordination of Benefits (COB) or ITS Home/Host claims.
• Ability to analyze claim details, benefit information, and supporting documentation to make accurate processing decisions.
• Strong attention to detail, critical-thinking skills, and commitment to quality.
• Ability to work effectively in a production-oriented, deadline-driven environment.
• Clear written and verbal communication skills.

This role is available as a Project Consultant W2 hourly contract only , with rates ranging from $30-35/hour based on relevant experience. Applicants must be U.S. Citizens , and we are unable to consider H-1B, C2C, or 1099 candidates. Project duration subject to change. #LI-DT1 #Remote

Posting Category Healthcare-Payer

Opportunity Type Project Consul