Huron
5001 - 10000 employees
Founded 2002
🏥 Healthcare
📦 Logistics
📣 Marketing
Healthcare • Logistics • Marketing
Huron Consulting Group is a global consultancy that provides a wide range of services including strategy, operations, advisory, digital, technology, and analytics solutions to various sectors such as healthcare, education, energy, and financial services. Huron helps organizations navigate complex challenges and drive growth through tailored solutions and innovative strategies. The company employs a team of experts dedicated to delivering high-impact solutions that address the unique needs of each client, focusing on areas such as managed services, outsourcing, and leadership development.
Facets Process & Documentation Specialist
🔥 1 minute ago
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Huron
5001 - 10000 employees
Founded 2002
🏥 Healthcare
📦 Logistics
📣 Marketing
Healthcare • Logistics • Marketing
Huron Consulting Group is a global consultancy that provides a wide range of services including strategy, operations, advisory, digital, technology, and analytics solutions to various sectors such as healthcare, education, energy, and financial services. Huron helps organizations navigate complex challenges and drive growth through tailored solutions and innovative strategies. The company employs a team of experts dedicated to delivering high-impact solutions that address the unique needs of each client, focusing on areas such as managed services, outsourcing, and leadership development.
📋 Description
• Design and document comprehensive health plan operations Desk Level Procedures (DLPs) • Translate business processes and Facets functionality into clear, step-by-step operational procedures • Develop standard workflows, exception-handling processes, and issue-resolution procedures • Align DLPs with Facets setup across membership, billing, claims, benefits, provider, and pricing modules • Translate operations logic into procedures for claims processing, adjustments, and issue resolution • Support troubleshooting of claims and benefit issues related to configuration gaps or system logic • Validate claims, adjudication workflows, and system dependencies • Develop procedures for investigating errors, identifying configuration issues, and executing corrections and reprocessing • Define root-cause identification steps, resolution actions, escalation paths, and cross-team dependencies • Partner with operational and IT teams to analyze recurring issues and improve procedures • Collaborate with Claims, Enrollment, Provider Configuration, IT, and Operations teams to define and validate processes • Translate complex technical and system concepts into business-friendly documentation • Support training initiatives with DLP documentation and operational guidance • Continuously enhance DLPs to improve efficiency, accuracy, consistency, issue-resolution timelines, and standardization • Support system implementations, conversions, and operational transformations with DLP development
🎯 Requirements
• 5+ years of experience working within Healthcare Payer operations • 5+ years of healthcare payer experience, including Medicare and Medicaid • 5+ years of hands-on experience with claims systems such as Facets, QNXT, or HealthRules • Experience with premium billing, claims processing, benefits/provider configuration, and operational workflows • Strong experience developing Desk Level Procedures (DLPs), SOPs, workflows, or operational documentation • Deep understanding of eligibility and premium billing • Deep understanding of claims adjudication processes • Deep understanding of benefits configuration and plan structures • Proven ability to translate complex processes into clear, step-by-step instructions • Proven ability to troubleshoot and resolve system/process-related issues • Experience in a consulting or client-facing environment • Experience building training materials or user guides • Experience with AI tools including Copilot, ChatGPT, and Claude
🏖️ Benefits
• Medical, dental, and vision coverage for employees and dependents • 401(k) plan with a generous employer match • Employee stock purchase plan • Paid Time Off policy • Paid parental leave • Adoption assistance • Wellness Program with free annual health screenings and coaching • Bank at work • On-site workshops • Ongoing programs recognizing major employee life events • Annual incentive compensation program • Other wellness programs
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