FACETS Functional Consultant – Healthcare Payer, Hybrid NC

Career Soft Solutions Inc; Durham (NC); Hybrid; USD 110,000 - 150,000; Full time

Job summary

Career Soft Solutions Inc seeks an experienced FACETS Functional Consultant with strong healthcare payer domain expertise and hands-on experience across FACETS modules, including Claims, Enrollment, Membership and Eligibility, Billing, Benefits and Provider Configuration. This is a long-term contract in North Carolina with hybrid work options.

Responsibilities include analyzing business requirements, translating them into FACETS configurations, supporting testing and production activities, and

Qualifications

• 8+ years of IT/Healthcare experience.
• 5+ years hands-on FACETS experience.
• Strong experience in multiple FACETS modules and end-to-end payer workflows.
• Healthcare payer or health insurance domain experience.

Responsibilities

• Support FACETS Claims configuration, processing, and adjudication.
• Analyze pricing, benefits, and eligibility impacts.
• Investigate denials, pend conditions, and processing issues.
• Support enrollment, billing, and premium reconciliation processes.
• Configure and support healthcare products, plans, and benefit structures.
• Coordinate with Claims and Benefits teams to resolve provider issues.

Skills

FACETS

SQL

Data analysis

Job description

Career Soft Solutions Inc seeks an experienced FACETS Functional Consultant with strong healthcare payer domain expertise and hands-on experience across FACETS modules, including Claims, Enrollment, Membership and Eligibility, Billing, Benefits and Provider Configuration. This is a long-term contract in North Carolina with hybrid work options.

Responsibilities include analyzing business requirements, translating them into FACETS configurations, supporting testing and production activities, and