Facets Benefits

4 weeks ago

Hyderabad, Telangana, India Cognizant Full time

About the job:

What makes Cognizant a unique place to work? The combination of rapid growth and an international and innovative environment This is creating many opportunities for people like YOU — people with an entrepreneurial spirit who want to make a difference in this world.

At Cognizant, together with your colleagues from all around the world, you will collaborate on creating solutions for the world's leading companies and help them become more flexible, more innovative, and successful. Moreover, this is your chance to be part of the success story.

Work Location: PAN India

Primary Skill: Facets Benefits / Pricing Configuration and Claim Validation

Position Summary:

We are seeking an experienced Facets Benefits / Pricing and Claim Validation Analyst or Quality Analyst to join Cognizant Healthcare team.. The ideal candidate will bring deep expertise in configuring the Facets Benefits / Pricing module, with a focus on provider contracting, claims adjudication, and benefit / pricing plan setup. This role requires a strong understanding of healthcare domain and hands-on experience with benefit/pricing and network configuration within the Facets platform.

Required kills:

  • Engineering / bachelor's degree or equivalent qualification with minimum 3-6 years of relevant hands-on experience in Facets Benefits or Pricing Configurations and Claim Validation.
  • Must have strong knowledge in API testing and EDI 278 transactions.
  • Hands on experience in SQL database testing is required.
  • Configure and maintain benefit / pricing structures within the Facets.
  • Set up and manage NetworX Pricer, Benefit Plans, and related configuration components
  • Collaborate with Provider Contracting teams to translate business rules into system configuration
  • Analyze and support Claims Adjudication processes related to benefits or pricing discrepancies or escalations
  • Ensure compliance with Medicare, Medicaid, and commercial payer guidelines
  • Participate in testing and validation of benefits or pricing setups to ensure accurate claim outcomes
  • Document configuration changes and maintain audit-ready records
  • Work with cross-functional teams including IT, business analysts, and QA to implement and troubleshoot system changes

Next Steps:

If you feel this opportunity suits you, or Cognizant is the type of organization you would like to join, we want to have a conversation with you Please apply directly with us.

For a complete list of open opportunities with Cognizant, visit http://www.cognizant.com/careers

Cognizant is committed to providing Equal Employment Opportunities. Successful candidates will be required to undergo a background check.

About Cognizant:

Cognizant (Nasdaq-100: CTSH) is one of the world's leading professional services companies, transforming clients' business, operating and technology models for the digital era. Our unique industry-based, consultative approach helps clients envision, build and run more innovative and efficient businesses. Headquartered in the U.S., Cognizant is ranked 185 on the Fortune 500 and is consistently listed among the most admired companies in the world. Learn how Cognizant helps clients lead with digital at www.cognizant.com or follow us @Cognizant.

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