Home
Jobs
Saved
Resumes
Encounter Data Manager – Facets at Huron | JobVerse
JobVerse
Home
Jobs
Recruiters
Companies
Pricing
Blog
Jobs
/
Encounter Data Manager – Facets
Huron
Remote
Website
LinkedIn
Encounter Data Manager – Facets
Illinois, United States of America
Full Time
1 hour ago
Visa Sponsor
Apply Now
About this role
Role Overview
lead end-to-end encounter submission processes, ensuring compliance with CMS and state Medicaid guidelines
monitor, analyze, and resolve encounter submission errors using automated workflows and root 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 proper adjudication outcomes
align 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 revenue leakage risks related to Medicare Advantage and Medicaid
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 healthcare payer experience (Medicare and Medicaid)
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 client-facing environments
ability to communicate with technical and non-technical staff
Benefits
medical, dental, and vision coverage to employees and dependents
a 401(k) plan with a generous employer match
an employee stock purchase plan
a generous Paid Time Off policy
paid parental leave and adoption assistance
wellness program supporting employee total well-being
Apply Now
Home
Jobs
Saved
Resumes