[Hiring] Sr. Facets Dental Configuration Specialist @Cognizant

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