Facets Process & Documentation Specialist

Remote – US based candidates only, no visa sponsorship available.

About the role

This role will lead operational priorities focused on execution quality, efficiency, safety, and measurable performance outcomes. You will collaborate with field leadership, support functions, and cross-functional stakeholders to improve accountability, service delivery, and operational consistency. The position offers the opportunity to influence operational scale, customer outcomes, and organizational performance within a Business Services environment.

Responsibilities

• Design and document comprehensive Desk Level Procedures for health plan operations
• Translate complex business processes into actionable operational procedures for end users
• Develop DLPs that include standardized workflows and issue resolution steps
• Ensure documentation aligns with current system behavior and business rules for Facets
• Collaborate with operational teams to ensure DLPs match system setups across multiple modules

Requirements

• 5+ years of experience in Healthcare Payer operations
• 5+ years of healthcare payer experience, including Medicare and Medicaid
• 5+ years of hands-on experience with claims systems like Facets, focusing on premium billing and claims processing
• Strong expertise in developing Desk Level Procedures (DLPs) and operational documentation
• Deep knowledge of eligibility, premium billing, and claims adjudication processes

Pay

$105,000 – $135,000 annually

Benefits

• Participation in the company’s annual incentive compensation program
• Access to medical, dental, and vision coverage
• Involvement in wellness programs