Facets US Healthcare at 2COMS Consulting in Telangana, IN

Job Summary

We are looking for professionals with hands-on experience in Facets and US Healthcare operations. The candidate will be responsible for supporting healthcare insurance processes, maintaining member and provider data, processing claims, and ensuring accurate and timely resolution of business requirements.

Key Responsibilities

• Work on Facets application for US Healthcare/Health Insurance processes.
• Handle healthcare insurance operations including claims, membership, enrollment, benefits, and provider-related activities.
• Process and validate member and policy information in Facets.
• Analyze and resolve claims and enrollment-related issues within defined SLAs.
• Perform data validation, reconciliation, and quality checks.
• Understand healthcare insurance concepts such as Medical Claims, Benefits, Eligibility, Enrollment, Providers, Members, and Plans.
• Investigate discrepancies and coordinate with relevant teams for resolution.
• Maintain accurate documentation and update process-related records.
• Identify process gaps and support continuous improvement initiatives.
• Follow defined quality standards, compliance requirements, and data privacy guidelines.
• Collaborate with internal stakeholders and business teams to resolve operational queries.

Role Purpose

The Analyst will be responsible for the accurate and timely execution of cash and position reconciliation tasks on a daily basis. Working under the guidance of the Team Lead, the Analyst will investigate and resolve reconciliation breaks, maintain exception logs, and ensure all processes are carried out in line with defined SOPs and quality standards. This role is foundational to the integrity of the reconciliation function.

Key Responsibilities

1. Cash Reconciliation

•Perform daily cash reconciliation across all accounts

•Match and clear cash entries across custodian statements and internal systems.

•Identify, document, and investigate cash breaks in a timely manner.

•Follow up with relevant teams (settlements, treasury, custodians) to resolve outstanding cash items.

2. Position Reconciliation

•Execute daily position reconciliation across equities, fixed income, and other assigned asset classes.

•Match portfolio holdings across front office, middle office, and custodian records.

•Investigate and document position breaks, including corporate action-related discrepancies.

•Escalate unresolved or complex position breaks to the Team Lead promptly.

3. Break Management & Resolution

•Maintain accurate and up-to-date break logs with investigation notes and resolution status.

•Follow defined escalation procedures for aged or high-value breaks.

•Liaise with internal teams and external counterparties to gather information needed for break resolution.

•Ensure breaks are cleared within SLA-defined timelines.

4. Controls & Documentation

•Adhere to all SOPs, maker-checker controls, and quality guidelines at all times.

•Maintain proper documentation of daily reconciliation activities and exception handling.

•Flag process deviations, system issues, or data anomalies to the Team Lead.

•Support periodic audits by providing required evidence and reconciliation records.

5. Reporting

•Prepare and submit daily reconciliation status reports and break summaries to the Team Lead.

•Update reconciliation trackers, dashboards, and exception logs accurately.

•Assist in preparing MIS data as required by the Team Lead or Team Manager.

Key Requirements

Experience & Skills

• 2 years of experience in financial services operations, preferably in reconciliation, settlements, or fund accounting.

•Basic understanding of cash flow, trade settlements, custodian processes, and asset classes.

•Familiarity with reconciliation tools (e.g., Intellimatch, AutoRek, SmartStream, or similar) is an advantage.

•Strong attention to detail with the ability to handle high-volume, repetitive processes accurately.

•Good communication skills — written and verbal.

•Proficiency in MS Excel (VLOOKUP, pivot tables, basic formulas); experience with data tools is a plus.

Education

•Bachelor's degree in Finance, Commerce, Accounting, Economics, or related field.

∙Perform quality control on medical review assessments generated by the medical review

process.

∙Develop a comprehensive understanding of medical management procedures.

∙Provide clear and concise negotiable points based on submitted medical records, identifying

necessary medical treatment, causally related care, response, or lack of response to

treatment, etc.

∙Identify and address missing records and information necessary for the completion of

medical review assessments.

∙Adhere to Department of Labour, state, and company timeframe requirements.

∙Coordinate physician reviewer referrals as needed and follow up timely to obtain and deliver

results.

∙Follow up on all pending claims appropriately and initiate the next steps.

∙Collaborate with the management team in the ongoing development and implementation of

utilization management programs.

∙Learn new methods and services as the job requires.

∙Advise supervisors of any potential problems as they become evident.

∙Manage the team’s workload within established performance standards.

∙Provide feedback to Team Leads and Managers on the performance of each associate and

the team as a whole.

∙Maintain and secure confidentiality of client data and all individually identifiable health

information accessed through the client’s and/or Cognizant’s systems.

∙Coordinate with immediate superiors regarding updates in policies, procedures, process flow,

and state requirements.

∙Learn new protocols and systems as the job requires.

∙Escalate to immediate superiors any unforeseen events or situations beyond assigned tasks

and jurisdiction.

∙Cross-train on multiple processes.

∙Handle difficult and complex transactions with stringent turnaround times and specific

requirements.

∙Complete missing information in provider details and update the database accordingly for

first-time providers and existing provider groups in client systems or databases.

Additional Responsibilities for Team Leader:****

∙Lead training sessions and workshops to enhance the team’s knowledge and skills in claims

adjudication.

∙Develop and implement best practices for claims management and ensure compliance with

industry standards.

∙Collaborate with cross-functional teams to improve process efficiency and effectiveness.

∙Monitor industry trends and updates to ensure the team is informed of the latest

developments in claims adjudication.

∙Conduct regular performance reviews and provide constructive feedback to team members.

∙Foster a positive and collaborative team environment, encouraging professional growth and

development.