[Hiring] Sr. Facets Dental Configuration Specialist @Cognizant

Remote Full-time
This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description As a Technical Analyst – Dental Configuration, you will make an impact by designing, developing, and optimizing benefit, pricing, and configuration solutions that directly enhance claim processing accuracy and auto‑adjudication rates. You will be a valued member of our configuration team and collaborate closely with clients, business partners, and technical stakeholders to deliver high‑quality, compliant configuration outcomes across multiple lines of business. • Lead client discussions to gather requirements related to GCP, Billing, Benefits, and Pricing Configuration. • Design and develop Dental Benefit and Pricing Configuration solutions aligned with business and regulatory objectives. • Serve as a subject matter expert for GCP/Billing/Benefit/NetworX configuration, reimbursement policies, coding standards, and editing rules. • Configure FACETS for new implementations, including group, class, plan, and product setup. • Conduct backend SQL queries to validate configuration accuracy and ensure correct claim processing behavior. • Partner with business teams to provide strategic guidance on configuration decisions and downstream impacts. • Apply comprehensive knowledge of Medicaid, Medicare, and commercial business rules across configuration activities. • Develop and deliver configuration strategies that successfully improve Auto Adjudication Rates for claims. Qualifications • 13+ years of hands‑on experience in Facets Dental Configuration, including Group, Class, Plan, Product, Provider Contracts, Pricing, Benefits Components, Service Groups, Fee Schedules, and related workflows. • Extensive knowledge of Dental Authorizations, Pre‑Determinations, and Dental Utilization Edits. • Strong understanding of Medicare, Medicaid, and commercial lines of business. • Advanced proficiency with the Facets backend data model and SQL, including query writing for configuration validation, claim analysis, and defect resolution. • Experience with dental claims processing and Coordination of Benefits (COB). • Ability to collaborate with clients and internal stakeholders to influence configuration strategy and design. Requirements • Experience configuring Vision, Life, and Disability products. • Deep subject matter expertise in reimbursement, editing standards, and provider contract configuration. • Demonstrated success improving auto‑adjudication and reducing claim rework. • Strong communication skills with the ability to translate complex configuration logic into actionable guidance for business partners. Benefits • Medical/Dental/Vision/Life Insurance • Paid holidays plus Paid Time Off • 401(k) plan and contributions • Long-term/Short-term Disability • Paid Parental Leave • Employee Stock Purchase Plan Apply tot his job
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