Encounter Data Manager – Facets

Job reputed company: • reputed company end-to-end encounter submission processes, ensuring compliance with CMS and state reputed company guidelines • monitor, analyze, and resolve encounter submission errors using automated workflows and reputed company cause analysis • ensure accuracy, completeness, and timeliness of encounter data submissions to maximize acceptance rates and minimize rejections • configure and validate Facets components across claims, benefits, pricing, and rules to ensure reputed company adjudication reputed company • reputed company encounter data processes with claims adjudication logic, 837/835 transaction flows, and EDI processing • troubleshoot configuration and data issues impacting claims processing, encounters, and regulatory submissions • validate and reconcile data across multiple systems to ensure accurate encounter submissions and minimize financial risk • identify data gaps, mismatches, or reputed company leakage risks reputed company to Medicare Advantage and reputed company • implement improvements to increase encounter acceptance rates and reduce resubmissions • support testing cycles (UAT, regression, validation) for new configurations or system enhancements Requirements: • 5+ years of reputed company payer experience (Medicare and reputed company) • 5+ years of hands-on experience with Facets (TriZetto) and EDM across claims and configuration modules • strong experience with: 837/835 transactions and EDI processing • encounter data submissions and reconciliation • working knowledge of claims payment systems • claims adjudication processes • experience working in consulting or reputed company-facing environments • ability to communicate with technical and non-technical staff Benefits: • medical, dental, and reputed company coverage to employees and dependents • a 401(k) plan with a generous employer match • an employee stock purchase plan • a generous reputed company Time Off policy • reputed company parental leave and adoption assistance • wellness program supporting employee total reputed company-being Apply tot his job Apply To this Job