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Facets Pricing Configuration
Ref No.: 17-17786
Location: Norfolk, Virginia
Responsibilities Include:
  • Work with customer to understand current bottle-necks to improving Auto-Adjudication specifically with respect to Auths and Duplicate Claims
  • Work independently to assess and identify areas where the AA rate can be improved.
  • Work with other technical and business teams that are focused on Claims Auto Adjudication improvement
  • Identify and document the business requirements needed to appropriately load providers per the state contract.

Must Have Skills:
  • Strong Healthcare Domain knowledge with indepth knowledge of Claims processing and Facets Configuration with respect to Duplicate Claims and UM Matching criteria
  • Prior experience with Customer assesments for Auto Adjudication rate improvements and solutions is desired