Healthcare Specialist

Quess corp is hiring for Lead Facets

7+years of Experience in Collaborate with consulting team members to configure and test healthcare products using the FACETS tool.

Utilize knowledge of SQL, ICD 9 and 10 codes, HIPAA, EDI Transactions (270/271), Medicare & Medicaid, and commercial insurance plans to ensure accurate configuration.

Handle configuration of products using FACETS, as well as tools such as MS Excel, MS Access, MS Word, and MS SQL.

Work on projects involving Product Benefits configuration, PCA (Processing Control Agent), and EDI 270/271, Networks.

Experience with Facets 5.1 and 5.4 Application and SQL server, including Agreement configuration.

Configure products in EDI 270/271 tables, both frontend and backend, to match product benefits and ensure expected responses in 271 for inquiries made in 270.

Familiarity with facets modules including PDPD, PLDE, ACCM, PLDS, SERL, SETR, PCAG, SEPY, LTLT, DEDE, etc.

Knowledge of Networks configuration and testing.

Handle tickets for all types of issues as per client requests.

Np-immediate -15days

location --Hyderabad