Catalyst Solutions provides end to end strategic, operational, and technical consulting for the payer industry. At Catalyst, we offer the consulting expertise of a “Big 4” firm while maintaining the client and cost-centric approach of a boutique. Specializing only in the healthcare industry, Catalyst offers customers unique industry insight into payer best practices.

• Ensure updates of CPT, HCPCS, DRG, and ICD-10 codes as well as pricing, billing rates, analysis, data entry, testing and documentation of configuration set up for all facets applications.• Translates business rules into effective and efficient configuration• Gathering and analyzing data in support of business cases, proposed projects and system requirements.• Prepare and deliver reports, recommendations or alternatives that address existing and potential trouble areas• Define operational requirements and system goals by meeting with decision makers and end users

• Facets membership enrollment and adjudication of tested claims(version 4.7)• Follows established parameters for Facets configuration, testing and debugging, provides build and release project/product components• Responsible for identifying necessary steps and processing claims of various complexity levels for Medicare, Medicaid, HMO, PPO, SNF, Rehab etc.• High productivity and accuracy rate processing overturned appeals; processed and adjust claims in accordance with the plans contracts utilizing facets version 4.7