Remote Facets NetworX Pricing Config Analyst

Tegria Services Group - US, Inc.; North Carolina; Sur place; USD 80 000 - 105 000; Plein temps

Avantages offerts par ce poste

Health and dental plans

Vision benefits

Wellness program

Remote work opportunities

Paid time off

Résumé du poste

Tegria Services Group - US, Inc. in North Carolina seeks a Facets NetworX Configuration Analyst to configure, maintain, and support provider reimbursement and pricing structures across Facets and NetworX.

You will translate contract terms into system configurations supporting claims adjudication and reimbursement. Collaborate with Contracting, Claims, IT, and Data Management teams to build and test reimbursement models, perform configuration updates, and ensure accurate pricing implementations.

Qualifications

• Bachelor's degree in Information Systems, Healthcare Administration, Business, or related field (or equivalent experience).
• 3+ years of Facets and NetworX configuration experience.
• Hands-on experience building and maintaining provider contracts within NetworX.
• Strong understanding of Facets core modules, including Membership, Provider Management, Claims Processing, Billing, Product/Benefits Configuration.
• Experience interpreting provider reimbursement methodologies and contract language.
• Proficiency with SQL and data analysis techniques.
• Strong analytical, troubleshooting, and problem-solving skills.
• Knowledge of healthcare payer operations, claims processing, and provider contracting.

Responsabilités

• Configure and maintain NetworX pricing components, including: Agreements, Rate Sheets, Rate Terms, Fee Schedules, Qualifier Groups, Networks, Provider Rows, Pricing Rules.
• Analyze provider contracts and reimbursement methodologies and translate contract language into system configuration requirements.
• Build, test, and support provider reimbursement models within Facets and NetworX environments.
• Perform configuration updates, maintenance, and enhancements related to provider pricing and contract management.
• Collaborate with Provider Contracting, Claims Operations, Provider Data Management, and IT teams to ensure accurate implementation of pricing requirements.
• Conduct unit testing, integration testing, and production validation for configuration changes.
• Troubleshoot pricing and claims adjudication issues and perform root cause analysis.
• Develop and execute SQL queries, data extracts, and reports to support configuration validation and operational analysis.
• Create and maintain configuration documentation, workflows, and standard operating procedures.
• Participate in system upgrades, implementations, and process improvement initiatives.

Connaissances

SQL

Data analysis

Analytical thinking

Troubleshooting

Payer operations

Formation

Bachelor's degree or equivalent experience

Outils

Facets

NetworX

Description du poste

Tegria Services Group - US, Inc. in North Carolina seeks a Facets NetworX Configuration Analyst to configure, maintain, and support provider reimbursement and pricing structures across Facets and NetworX.

You will translate contract terms into system configurations supporting claims adjudication and reimbursement. Collaborate with Contracting, Claims, IT, and Data Management teams to build and test reimbursement models, perform configuration updates, and ensure accurate pricing implementations.