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Hourly Remote Facets Configuration Jobs (NOW HIRING)

HealthEdge

Test Manager

$120K - $140K/yr

Lead test execution for claims adjudication, enrollment, benefits configuration, EDI transactions ... S. healthcare payer platforms (e.g., TriZetto QNXT/Facets, NICE/IntelliSource, Macess, Salesforce ...

HealthEdge

Test Manager

$120K - $140K/yr

Lead test execution for claims adjudication, enrollment, benefits configuration, EDI transactions ... S. healthcare payer platforms (e.g., TriZetto QNXT/Facets, NICE/IntelliSource, Macess, Salesforce ...

Focused HR Solutions

Java Developer 1-20-

Phoenix, AZ · Remote

$55 - $70/hr

100% Remote Our direct client has an opening for a Java Developer Please send us your rate and ... Familiar with all facets of the software development lifecycle; preferably with Agile Scrum ...

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Hourly Remote Facets Configuration information

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How much do hourly remote facets configuration jobs pay per year?

As of Sep 6, 2026, the average yearly pay for hourly remote facets configuration in the United States is $95,935.00, according to ZipRecruiter salary data. Most workers in this role earn between $76,000.00 and $112,000.00 per year, depending on experience, location, and employer.

What are the most commonly searched types of Remote Facets Configuration jobs?

The most popular types of Remote Facets Configuration jobs are:

Hourly Remote Facets Configuration jobs near you
Infographic showing various Hourly Remote Facets Configuration job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 48% Full Time, 46% Part Time, 1% Temporary, 3% Contract, and 1% Nights. Highlights an 98% Physical, and 2% Remote job distribution, with an average salary of $95,935 per year, or $46.1 per hour.

Senior Provider Network Operations Analyst

Amerihealth Caritas

Southfield, MI • Remote

Full-time

Posted 4 days ago

AmeriHealth Caritas rating

8.3

Company rating: 8.3 out of 10

Based on 73 frontline employees who took The Breakroom Quiz

133rd of 315 rated insurance

Job description

Role Overview: The Senior Provider Network Operations Analyst serves as a subject matter expert within Provider Network Operations and is responsible for operational accuracy, regulatory compliance, claims configuration, provider data, and related network operations.

Work Arrangement:

  • Remote - This position is fully remote; the associate must be located in Michigan (MI and attend monthly meetings as needed in Southfield, MI.
  • Requires reliable high-speed internet (minimum 50 Mbps download / 5 Mbps upload)
  • Internet reimbursement may be available where required by law or contract

Responsibilities:

  • Review/approve and audit Payment Integrity (PI) vendor and internal prospective and retrospective edits/projects/recoveries.
  • User Acceptance Testing (UAT)/Client Review & audit (provider data, Appian Advanced Group ID (AGID) configuration, and set-up concentration) reviews requests prior to initial submission to Enterprise Operations (EO) and claims post-production.
  • Facets claims edit configuration concentration (Appian) - intake, review, impact assessment, and initial submission; UAT reviews requests prior to initial submission to EO and claims post-production.
  • Encounter error reconciliation representation, oversight, and management - including identification and initiation of claim or provider changes necessary to mitigate/prevent future errors.
  • Management and resolution of state complaints.
  • State policy and contract amendment changes analysis and management.
  • Internal or vendor medical policy or Health Value Optimization (HVO) edit changes and initiatives.
  • Monitor and review state communications and changes, lead initial analysis/determination of action, provide direction on work request submissions to level I analysts, and test/audit subsequent changes.
  • Business Process Outsourcing (BPO) and/or other intake/workflow tool management.
  • Single-case agreement management/ownership, including letter development and coordination with Provider Network Management (PNM).
  • Serves as the subject matter expert in state-specific health reimbursement rules and provider billing requirements and as liaison to the Enterprise Operations Configuration Department.
  • Maintain a current working knowledge of processing rules, contractual guidelines, state/Plan policy, and operational procedures to effectively provide technical expertise and business rules.
  • Acts as the resource to other departments by developing and managing work plans which document the status of key relationship issues and action items for high-profile providers.
  • Performs other related duties and projects as assigned

Education & Experience:

  • American Academy of Professional Coders (AAPC) certification (CPC, COC, CIC, CRC) or NHA (CBCS) certification required.
  • Associate's degree preferred, or equivalent combination of education and experience in a healthcare field.
  • 3 to 5 years of claims analysis experience in healthcare, managed care, or Medicaid environment preferred.
  • Claims processing and Provider data maintenance knowledge required
  • Understanding of and experience related to healthcare claims payment configuration process/systems and its relevance/impact on network operations required
  • Strong working knowledge of Microsoft Excel, Access, Word, and other MS Office tools; ability to work with pivot charts, Access databases, and data analytics.

Skills & Abilities:

  • Ability to focus on technology and business issues, as well as communicate appropriately with both technology and business experts
  • Strong analytic problem-solving skills
  • Superior organizational skills required
  • Critical thinking skills
  • Strong customer service skills
  • Data and reporting analysis
Employment Type: FULL_TIME

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