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Facets Claims Processors - COB - ITS Home Host

Role overview

Qualifications

  • Must have current and hands-on experience as a Facets Claims Examiner
  • Demonstrated experience manually processing healthcare claims
  • Current experience manually processing either Coordination of Benefits (COB) or ITS Home/Host claims
  • Strong attention to detail, critical-thinking skills, and commitment to quality

Responsibilities

  • Manually review, evaluate, and process healthcare claims within the Facets platform
  • Research and resolve complex claim scenarios requiring interpretation of benefits, plan provisions, payment rules, and supporting documentation
  • Process claims involving Coordination of Benefits (COB) and/or ITS Home/Host
  • Collaborate with team members and client stakeholders to support timely and accurate claim resolution

Key facts

Hard skills

Other skills

  • Detail Oriented
  • Critical Thinking
  • Communication

About the company

Huron logo

Huron

Management Consulting

Huron is a global professional services firm that collaborates with clients to put possible into practice by creating sound strategies, optimizing operations, accelerating digital transformation, and empowering businesses and their people to own their future. By embracing diverse perspectives, encouraging new ideas, and challenging the status quo, we create sustainable results for the organizations we serve. Learn more at huronconsultinggroup.com.

Company details

Company typeLarge
IndustryManagement Consulting
Company size5001 - 10000

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Job description

The Opportunity

At Huron, we’re redefining what a consulting organization can be. We go beyond advice to deliver results that last. We inherit our client’s challenges as if they were our own. We help them transform for the future. We advocate. We make a difference. And we intelligently, passionately, relentlessly do great work…together.


Are you the kind of person who stands ready to jump in, roll up your sleeves and transform ideas into action? Then come discover Huron.


Whether you have years of experience or come right out of college, we invite you to explore our many opportunities. Find out how you can use your talents and develop your skills to make an impact immediately. Learn about how our culture and values provide you with the kind of environment that invites new ideas and innovation. Come see how we collaborate with each other in a culture of learning, coaching, diversity and inclusion. And hear about our unwavering commitment to make a difference in partnership with our clients, shareholders, communities and colleagues.


Huron Consulting Group offers a competitive compensation and benefits package including 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; and paid parental leave and adoption assistance. Our Wellness Program supports employee total well-being by providing free annual health screenings and coaching, bank at work, and on-site workshops, as well as ongoing programs recognizing major events in the lives of our employees throughout the year. All benefits and programs are subject to applicable eligibility requirements.
Huron is fully committed to providing equal employment opportunity to job applicants and employees in recruitment, hiring, employment, compensation, benefits, promotions, transfers, training, and all other terms and conditions of employment. Huron will not discriminate on the basis of age, race, color, gender, marital status, sexual orientation, gender identity, pregnancy, national origin, religion, veteran status, physical or mental disability, genetic information, creed, citizenship or any other status protected by laws or regulations in the locations where we do business. We endeavor to maintain a drug-free workplace.

Position Summary

Huron is a global consultancy that collaborates with clients to drive strategic growth, ignite innovation and navigate constant change. Through a combination of strategy, expertise and creativity, we help clients accelerate operational, digital and cultural transformation, enabling the change they need to own their future.

Huron’s HDTx Payer Services team is seeking experienced Facets Claims Examiners for an hourly assignment supporting a large payer with processing complex healthcare claims operations. This role is ideal for claims professionals with strong Facets expertise, sound judgment, and demonstrated experience manually reviewing and processing claims that require detailed analysis and interpretation.

Qualifications

Key Responsibilities

  • Manually review, evaluate, and process healthcare claims within the Facets platform.
  • Research and resolve complex claim scenarios requiring interpretation of benefits, plan provisions, payment rules, and supporting documentation.
  • Process claims involving Coordination of Benefits (COB) and/or ITS Home/Host, including validation of primary and secondary payer responsibility.
  • Identify claim discrepancies, determine appropriate resolution, and document claim-processing decisions accurately.
  • Apply established policies, procedures, and client-specific requirements while meeting quality and productivity expectations.
  • Escalate claims issues, system concerns, or processing trends when additional review is required.
  • Collaborate with team members and client stakeholders to support timely and accurate claim resolution.

Required Qualifications

  • Must have current and hands-on experience as a Facets Claims Examiner, with advanced working knowledge of Facets claims processing (not Configuration).
  • Demonstrated experience manually processing healthcare claims, including complex and exception-based scenarios.
  • Current experience manually processing either Coordination of Benefits (COB) or ITS Home/Host claims.
  • Ability to analyze claim details, benefit information, and supporting documentation to make accurate processing decisions.
  • Strong attention to detail, critical-thinking skills, and commitment to quality.
  • Ability to work effectively in a production-oriented, deadline-driven environment.
  • Clear written and verbal communication skills.

This role is available as a Project Consultant W2 hourly contract only, with rates ranging from $30-35/hour based on relevant experience. Applicants must be U.S. Citizens, and we are unable to consider H-1B, C2C, or 1099 candidates.  Project duration subject to change.

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Posting Category

Healthcare-Payer

Opportunity Type

Project Consultant (Fixed Term)

Country

United States of America

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MR

Marcus Rivera

Chief Revenue Officer

m.rivera@company.com
linkedin.com/in/marcusrivera
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