Facets Business System Analyst

Facets experience - Relevant Facets exposure across member enrollment, provider enrollment, eligibility, adjudication, and provider contracting modules. Experience appears primarily from a System Analyst perspective.

Benefits knowledge - Strong knowledge of eligibility, enrollment, benefit plans, coverage rules, and 270/271 transactions. Demonstrated a clear understanding of how benefits impact claims adjudication.

Claims adjudication knowledge - Good understanding of claims adjudication workflows, provider pricing, claim validations, denials, remittance advice, UAT, and production support activities

Requirements analysis - Strong requirements gathering and analysis skills. Demonstrated experience with stakeholder workshops, process mapping, business requirements, wireframes, prioritization, and translation into technical specifications.

SQL/data analysis - Comfortable using SQL for root cause analysis, data validation, troubleshooting, and UAT support. Demonstrated a structured approach to investigating data issues.

Production issue investigation - Provided a solid example of investigating eligibility-related production issues, performing RCA, coordinating with ETL teams, and driving resolution while communicating effectively with business stakeholders.

Communication and documentation examples - Demonstrated strong stakeholder communication and documentation experience, including BRDs, workflow diagrams, data mapping documents, UAT artifacts, release notes, and defect tracking.