Remote Facets Claims Examiner (Contract)

Hsmconsulting; Chicago (IL); Remote; USD 41,000 - 48,000; Full time

Job summary

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

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.

Skills

Attention to detail

Critical thinking

Clear communication

Tools

Facets

Job description

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.