Functional Analyst – EDI​/Facets

Functional Analyst – 834 EDI / Facets

Lumen Solutions Group Inc. is a technology consulting Services company based in Florida. We provide a wide array of experienced business and IT professionals supporting clients from solution design to implementation and support. We specialize in professional IT consulting services, IT Staffing, Business/IT Strategy, Business Process Blueprints, Enterprise Architecture, and Enterprise Transformation.

Location:

Baltimore, MD (Remote – Required Once in a Quarter)

Job Type: 6 Months Contract-To-Hire

Job Summary:

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.

Key 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.

Required Skills & Qualifications

• Mandatory: EDI 834 Eligibility experience with strong knowledge of the 834 file layout.
• Mandatory:
  Facets experience preferably Facets G6;
  Facets Legacy is also acceptable.
• Experience with eligibility file data analysis, testing, validation, and reconciliation.
• Healthcare payer/claims/enrollment experience strongly preferred.
• 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.

Lumen Solutions Group Inc is an equal opportunity employer. All qualified applicants will be considered for employment without regard to any legally protected status.