Healthcare System Analyst - Payer Systems
SoftPathTechnologies
Location: Woodland Hills, CA / Mason, OH
Work Arrangement: Onsite
Employment Type: W2 Only Job Summary
We are seeking an experienced Healthcare System Analyst Payer Systems with strong hands-on experience working with the Facets platform and a deep understanding of healthcare payer processes. The ideal candidate will have strong Benefits and Claims knowledge, excellent SQL/data troubleshooting skills, and experience taking ownership of production issues from investigation through resolution.
Key Responsibilities- Analyze and support end-to-end healthcare payer system processes.
- Work with Eligibility & Enrollment, Benefits, Provider Contract Pricing, Claims Adjudication, Billing, Appeals, and Grievances .
- Provide hands-on technical/system analysis support for the Facets platform .
- Understand and troubleshoot Facets data models, application architecture, and business process flows .
- Investigate production issues using SQL and data analysis techniques.
- Perform root-cause analysis and coordinate with development, business, QA, and technical teams to resolve production issues.
- Gather and analyze business requirements and translate them into clear functional and technical requirements .
- Prepare and maintain functional specifications, technical documents, system requirements, and process documentation .
- Collaborate with business stakeholders and technical teams throughout the development and implementation lifecycle.
- Analyze data and system behavior to identify defects, configuration issues, and data-related problems.
- Take ownership of assigned production issues and drive them through resolution.
- Strong experience as a Healthcare System Analyst within the payer/health insurance domain.
- Hands-on experience with TriZetto Facets .
- Strong knowledge of Facets Benefits and Claims .
- Strong understanding of healthcare payer processes and workflows.
- Strong SQL skills with hands-on data troubleshooting experience.
- Understanding of Facets data models and architecture .
- Experience with .NET/C# is preferred.
- Full-stack technical experience is a plus.
- Strong experience with requirements gathering and preparation of functional and technical documentation .
- Excellent analytical, troubleshooting, and problem-solving skills.
- Strong communication skills with the ability to work with both business and technical teams.
The ideal candidate will have:
- Deep hands-on Facets System Analyst experience.
- Strong Benefits and Claims expertise.
- Proven ability to troubleshoot complex production issues .
- Strong SQL and data analysis capabilities.
- Experience performing root-cause analysis and resolving real production issues.
- Ability to independently investigate problems and work across business and technical teams to deliver solutions.
W2 candidates only.
Accepting:
- US Citizens / USC
- Green Card / GC
- H-4 EAD
Independent candidates only. No C2C or third-party submissions.
Location Woodland Hills, CA Onsite
Mason, OH Onsite
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