Healthcare System Analyst Payer Systems

Job Title: Healthcare System Analyst – Payer Systems
Location: Woodland Hills, CA / Mason, OH – Onsite
Rate: $60/hr C2C or $50–$52/hr W2
Full-Time Salary: $130K

Role Overview
We are seeking a Healthcare System Analyst – Payer Systems with strong hands-on experience supporting healthcare payer systems, particularly Facets. The ideal candidate should have a strong understanding of healthcare processes, including Eligibility & Enrollment, Provider Contract Pricing, Claims Adjudication, Billing, Appeals, and Grievances.

Key Responsibilities & Requirements

• Strong experience as a Healthcare System Analyst with hands-on experience in Facets.
• Deep understanding of healthcare payer processes, including:
  • Eligibility & Enrollment
  • Provider Contract Pricing
  • Claims Adjudication
  • Billing
  • Appeals & Grievances
• Strong understanding of Facets architecture, data models, and end-to-end process flows from a technical/developer perspective.
• Strong SQL skills for data analysis, troubleshooting, and production issue investigation.
• .NET / Full Stack technical knowledge is preferred.
• Experience working closely with both business and technical teams to gather and document system requirements.
• Ability to create technical and functional specifications/documentation.
• Strong experience troubleshooting healthcare payer data and production issues.
• Demonstrated ownership of real-world production issues, including root-cause analysis and resolution.
• Strong benefits and claims domain knowledge is highly preferred.

Have a Great Day!
Warm Regards,
Sania Wadhwa
Technical Recruiter
Contact Details: 609-755-5388
Email:

sania@applabsystems.com

4365 Route 1 South,Suite 105
Princeton, NJ 08540
www.applabsystems.com