FACETS Claims adjudication system training
FACETS Claims Adjudication System Training gives in-depth information and hands-on experience with FACETS, a popular software for healthcare claims processing. Participants learn how to navigate the system, manage claims throughout the lifecycle, and guarantee that healthcare claims are adjudicated accurately.
- 10+ Courses
- 30+ Projects
- 400 Hours
FACETS Claims adjudication system Training is suitable for the following target audiences:
Claims Processors: Claims Processors require expertise in the FACETS system to manage and judge insurance claims properly.
Healthcare Administrators: Healthcare administrators need knowledge of FACETS to enable prompt and accurate claims adjudication.
Business Analysts: This course is ideal for healthcare business analysts seeking to optimize claims processing workflows through a specialist understanding of FACETS.
IT Support Staff: Training for IT workers who support and manage the FACETS system, including troubleshooting and optimizing claims procedures.
Insurance Adjusters: Understanding the FACETS system is essential for insurance adjusters working in the healthcare industry to evaluate and process claims properly.
FACETS Claims Adjudication System Training equips individuals for many responsibilities in the healthcare industry, including work opportunities in the USA.
Claims Processor: Responsible for assessing and processing healthcare claims using FACETS while adhering to standards and norms.
Claims Analyst: Claims Analysts analyze claim data, detect trends, and resolve inconsistencies to improve claim processing efficiency.
FACETS Administrator: Sets up and maintains the FACETS system, implements upgrades, and provides technical support to users.
Healthcare IT Specialist: Helping to integrate FACETS with other healthcare systems, enabling smooth data flow and system compatibility.
These positions are crucial in healthcare organizations, insurance companies, and managed care organizations across the United States, providing chances for professional development and progress in healthcare administration and information technology.
- Basics of US healthcare (Payers, Providers, Members)
- Health insurance concepts (HMO, PPO, EDI, HIPAA)
- Overview of Claims Adjudication Lifecycle
- Introduction to the FACETS system
- FACETS modules (Membership, Billing, Claims, Provider, Finance)
- FACETS User Interface navigation
- Member Enrollment & Eligibility Setup
- Group, Plan, and Product setup
- Provider records setup and relationships
- Coordination of Benefits (COB) setup
- Understanding HIPAA-related data fields
- Types of claims (Professional vs Institutional)
- Claims routing and workflow
- Adjudication rules engine
- Manual claims entry and adjustment
- Claims suspension, edits, pends, and resolution
- Code sets: ICD-10, CPT, HCPCS, Revenue Codes
- Billing structure in FACETS
- Capitation vs Fee-for-service
- Claims payments and Explanation of Benefits (EOB)
- Standard FACETS reports
- Data extraction basics (reporting tools or SQL view into FACETS DB if allowed)
Capstone Project:
- Simulate processing claims for a small healthcare scenario
- Setup members, providers, and submit & adjudicate claims
- Identify and fix a pend/edit
- Prepare a reporting summary
Career Support:
- Resume and interview preparation (e:g Claims Analyst ,FACETS System Analyst ,Healthcare Business Analyst)
- Preparation for the Certification path (AHIP, CPC, or payer-specific onboarding)
Note: Curriculum for FACETS Claims Adjudication System Training is ideal for aspiring healthcare analysts, claims processors and IT professionals entering the healthcare domain. FACETS is widely used by payers in the US healthcare system, so the training focuses on both domain knowledge and system navigation. Curriculum will be modified as per the latest standards.
FACETS is a leading core administration system used by major health insurance companies to manage claims, members, billing, and providers. Learning FACETS opens up career paths in healthcare IT, claims analysis, and payer operations.
No prior healthcare experience is required. The course starts with healthcare domain basics and builds up to FACETS functionality.
The training lasts for 2 months, including theory sessions, hands-on practice, and a capstone project simulating real-world claims processing.
Yes, you will get practical exposure through simulations or access to a training environment, where you’ll perform activities like entering claims, updating member data, and resolving pends.
Yes, you’ll receive a Certificate of Completion from Checkmate IT Tech, which can be added to your resume and LinkedIn profile.
Yes! We offer:
- Resume building and LinkedIn profile support
- Mock interviews and interview guidance
- Job referrals through our hiring network
We currently offer online sessions with flexible weekday/weekend batches. All sessions are recorded. You’ll have access to the recordings, along with support from instructors and peers in our learning portal.
You can enroll via our website or contact our support team directly via email or phone. We’ll guide you through the quick and easy registration process.
https://checkmateittech.com/
Email info@checkmateittech.com OR Call Us +1-347-4082054
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Job opportunities in USA and Canada
FACETS Claims Adjudication System Training equips individuals for many responsibilities in the healthcare industry, including work opportunities in the USA.
Claims Processor: Responsible for assessing and processing healthcare claims using FACETS while adhering to standards and norms.
Claims Analyst: Claims Analysts analyze claim data, detect trends, and resolve inconsistencies to improve claim processing efficiency.
FACETS Administrator: Sets up and maintains the FACETS system, implements upgrades, and provides technical support to users.
Healthcare IT Specialist: Helping to integrate FACETS with other healthcare systems, enabling smooth data flow and system compatibility.
These positions are crucial in healthcare organizations, insurance companies, and managed care organizations across the United States, providing chances for professional development and progress in healthcare administration and information technology.
