Healthcare Domain Specialist

6 days ago

Hyderabad, Telangana, India beBeeConfiguration Full time ₹ 12,00,000 - ₹ 17,40,400

About the position:

You will collaborate with colleagues worldwide to create solutions for leading companies, enhancing their flexibility, innovation, and success.

This role demands a deep understanding of the healthcare domain and hands-on experience with benefit/pricing and network configuration within the Facets platform.

  • Configure and maintain benefit/pricing structures within the Facets.
  • Set up and manage NetworX Pricer, Benefit Plans, and related configuration components.
  • 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.

The ideal candidate possesses excellent problem-solving skills, strong analytical capabilities, and effective communication skills.

Key responsibilities include:

Benefit structure design and implementation, Pricing strategy development, Network configuration management, Claims adjudication process analysis, Regulatory compliance maintenance

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