Functional Analyst – 834 EDI / Facets

Lumen Solutions Group Inc • Baltimore, MD

2d • Hybrid

About The Position

Seeking a Functional Analyst with strong EDI 834 Eligibility and Facets experience to analyze, validate, test, and audit eligibility files. The role will ensure vendor files meet required layouts, specifications, and business requirements before production, while supporting data analysis and process improvement initiatives.

Requirements

• EDI 834 Eligibility experience with strong knowledge of the 834 file layout.
• Facets experience preferably Facets G6; Facets Legacy is also acceptable.
• Experience with eligibility file data analysis, testing, validation, and reconciliation.
• Strong analytical, problem-solving, documentation, and communication skills.
• Advanced Excel and data analysis skills.
• Bachelor's degree or equivalent experience.
• 4+ years Functional Analyst experience or 6+ years operational/analytical experience.

Nice To Haves

• Healthcare payer/claims/enrollment experience strongly preferred.

Responsibilities

• Review and validate EDI 834 eligibility file layouts, specifications, and data.
• Perform data analysis, testing, reconciliation, and auditing of eligibility files.
• Validate vendor files against business and system requirements before production.
• Reconcile eligibility data with claims/member data to identify discrepancies.
• Support QA/testing, enrollment processes, and production implementations.
• Analyze operational processes, identify gaps, and recommend improvements.
• Gather requirements, document processes/SOPs, and prepare reports and analysis.
• Monitor KPIs and support business/operational improvement initiatives.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level