Facets Consultant (Enrollment, Billing & Claims)

🏢 Recruiting Company: Four Ways Consulting

🌍 Job Location: Hybrid | Any Infosys Office Location

💼 Job Type: Contract / Contract-to-Hire

📧 Application Method: Send your resume to [[email protected]](https://techjunction.co/cdn-cgi/l/email-protection)

✓ 4 Open Positions ✓ Hybrid Work Model ✓ Contract / Contract-to-Hire Opportunity ✓ Healthcare Payer Domain Focus ✓ Immediate Hiring Requirement

💡 Position Summary

Four Ways Consulting is seeking experienced Facets Consultants to support healthcare payer operations involving enrollment, billing, and claims management proce sses. This role is ideal for professionals with strong TriZetto Facets expertise, healthcare domain knowledge, and database skills who can contribute to implementation, support, data analysis, and business proce ss optimization initiatives.

📜 Detailed Job Description

As a Facets Consultant, you will work closely with business users, technical teams , and healthcare operations stakeholders to support and enhance core healthcare payer systems . You will participate in the configuration, analysis, troubleshooting, and optimization of Facets modules related to enrollment, billing, and claims proce ssing. The role requires strong knowledge of healthcare payer workflows, data structures, and regulatory requirements. You will leverage PostgreSQL , PSQL , and SQL skills to perform data analysis, reporting, issue resolution, and system validation activities. This is an excellent opportunity to work on large-scale healthcare technology platforms supporting critical payer operations and member services.

✅ Key Responsibilities

✓ Support and enhance TriZetto Facets Enrollment, Billing, and Claims modules

✓ Analyze business requirements and transla te them into Facets configuration and system solutions

✓ Troubleshoot application, data, and proce ssing issues across healthcare payer workflows

✓ Perform data validation, reconciliation, and root cause analysis using PostgreSQL and SQL

✓ Support healthcare enrollment proce sses including member onboarding and maintenance

✓ Manage claims proce ssing analysis, adjudication validation, and issue resolution activities

✓ Support premium billing, payment proce ssing, and financial reconciliation workflows

✓ Collaborate with business, operations, and development teams to implement system improvements

✓ Create and maintain functional specifications, documentation, and support proce dures

✓ Participate in testing, deployment, and production support activities

✓ Ensure compliance with healthcare industry standards and operational requirements

🎓 Required Qualifications & Skills

✓ Strong hands-on experience with TriZetto Facets platform

✓ Expertise in Facets Enrollment, Billing, and Claims modules

✓ Experience working within Healthcare Payer organizations

✓ Strong knowledge of healthcare insurance and payer business proce sses

✓ Hands-on experience with PostgreSQL (PSQL ) and SQL

✓ Ability to write complex queries, analyze data, and troubleshoot production issues

✓ Experience supporting claims proce ssing and member enrollment workflows

✓ Understanding of healthcare data models and transaction proce ssing

✓ Strong analytical, problem-solving, and troubleshooting skills

✓ Excellent communication and stakeholder management abilities

✓ Ability to work effectively in hybrid and cross-functional environments

✨ Nice-to-Have Skills

✓ Experience with Facets implementation or upgrade projects

✓ Knowledge of EDI transactions including 834, 835, and 837 formats

✓ Experience with healthcare membership and provider management systems

✓ Familiarity with Medicare, Medicaid, and commercial health plans

✓ Experience with healthcare reporting and analytics tools

✓ Exposure to Agile delivery methodologies and DevOps environments

💡 Recruitment Pro Tip

For Facets consulting roles, hiring managers prioritize candidates who can demonstrate real-world experience supporting Enrollment, Billing, or Claims operations within healthcare payer organizations. Highlight specific Facets modules you’ve worked on, production issues resolved, claims volumes supported, proce ss improvements delivered, and examples where your SQL and PostgreSQL expertise helped solve critical business or operational challenges.

To apply for this job email your details to [[email protected]](https://techjunction.co/cdn-cgi/l/email-protection#5427353d3214323b212623352d27373b3a272138203d3a337a373b396b2721363e31372069152424383d3735203d3b3a716664223d35716664123537312027716664173b3a27213820353a2071666471666c113a263b383839313a20716617716664163d38383d3a337166647166627166641738353d392771666d716664716317716664123b212671666403352d27716664173b3a272138203d3a337166647163177166641c2d36263d3071666471666c153a2d7166641d3a323b272d277166641b32323d373171666d716664383d27203d3a337166643b3a7166643c202024277167157166127166122031373c3e213a37203d3b3a7a373b)

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