FACETS Claims Adjudication System

Facets (Trizetto Claims processing system) provides several functionality which is supported under the application group or you can call modules.It helps the organizations to perform their day to day operational work••  by utilizing any or all of the application groups.

Facets is a registered trademark of••  Trizetto.Facets is a client/server based system ,developed in JAVA technology and all the business rules are running behind the scene as a core functionality.It allows the industry users to be in compliant with all the latest mandates and legislation as long as the latest version of the solution is in place by the Facets users.

Facets implementation allows the integration with many 3rd party applications and the most common one is the claims Xten or TPS (Total Payment system). This type of integrations help the organizations to reduce cost and gain high value from the cost saving prospective.

Facets have two sides of the jobs in the market which are very demanding.One hand there are less skilled resource available ,but••  industry needs more resources to fulfill all the federal/state mandates.

Key Feature:

• A Best suited solution of the healthcare management
• A Very demanding for handling managed care products
• A Very robust and user friendly user interface
• Allow great security level with the user roles and access level management
• We have a deep understanding of the healthcare IT industry
• We have flexible approaches to meet your current needs.
• 20+ Hrs of High Quality e-Learning Content
• Advance curriculum and in sync with latest Healthcare IT standards
• Real Time Projects and Assignments
• Role specific Training
• Resume and Interview Tips
• Real time projects / assignments
• 100% money back
• Have questions / clear your doubts with the Industry experts.

Placement Assistance

• Job oriented program
• No Pre-requisites
• Hands on Training on Multiple Industry Tools
• Resume Preparation
• Mock-up Interviews
• Job Marketing
• Rejoin the Course
• On Job support
• Real Time Lab Access
• Real Time Project Experience and Case Studies
• Role specific Training
• Candidates referrals
• Interview preparation
• Sourcing candidates
• Interview coordination
• Preference to OPT & CPT candidates
• H1B Sponsor ship
• All Benefits - Medical, vacation, Life Ins, 401k

Eligibility:

• IT Business Analysts and System Analysts
• IT Quality Assurance (Testing).
• Project Team Members.
• Non IT professionals aspiring to get into Healthcare IT Industry.
• Self-taught IT Business Analysts and Quality Assurance wanting to fill in the gaps and put all the pieces together
• Technical people who are interested in expanding their role into Healthcare IT.
• Executives and Managers want to get into Healthcare Industry

FACETS system:

• MOEDULE Accounting Application Group
• MOEDULE Accumulator Application Group
• MOEDULE Application support Application Group
• MOEDULE Benefit Configuration Application Group
• MOEDULE Billing Application Group
• MOEDULE HIPAA Privacy Application Group
• MOEDULE Capitation Application Group
• MOEDULE Claims Process Application Group
• MOEDULE Claims processing-ITS Application Group
• MOEDULE Commission Application Group
• MOEDULE Criteria Application Group
• MOEDULE Customer Service Application Group
• MOEDULE Dental Plans Application Group
• MOEDULE Dental provider agreement Application Group
• MOEDULE FSA Plan Application Group
• MOEDULE ITS Application Support
• MOEDULE ITS Plan Application Group
• MOEDULE Medical Plan Application Group
• MOEDULE Provider NetworkX Application Group
• MOEDULE Provider agreement Application Group
• MOEDULE Pricing Profile Application Group
• MOEDULE Provider Application Group
• MOEDULE Subscriber Application Group
• MOEDULE Utilization Management Application Group
• MOEDULE Workflow Configuration Application Group
• MOEDULE Architecture / SOA / EAI Consulting
• MOEDULE Facetsâ„•¢ Security
• MOEDULE Infrastructure Assessment & Planning
• MOEDULE Environment Development and Management
• MOEDULE Data Conversion Support
• MOEDULE Provider Configuration issues
• MOEDULE Facetsâ„•¢ Batch Processing Optimization
• MOEDULE Third Party Application Integration using Facetsâ„•¢ eXtended Integration (FXI)
• MOEDULE EDI Solutions including TriZetto’s HIPAA Gateway••®
• MOEDULE Business Intelligence, Analytics and Reporting

QNXT:

• MOEDULE Medical and dental claims processing
• MOEDULE Manual Claims re-pricing
• MOEDULE Capitation/risk fund management
• MOEDULE Hospital and medical pre-authorization
• MOEDULE Case Management
• MOEDULE Implementation Assessments & Strategy
• MOEDULE Project Planning & Management
• MOEDULE Business Analysis / Requirements Definition
• MOEDULE Process Design & Improvement
• MOEDULE Customer service support
• MOEDULE Premium billing support and customized reporting
• MOEDULE Provider Network Management including minimizing the provider data load issues
• MOEDULE Group/membership administration support
• MOEDULE Referral management
• MOEDULE Workflow Implementation
• MOEDULE Claims Analysis, Payment Validation and Backlog Reduction
• MOEDULE QA & Testing for QNXT migration and Implementation
• MOEDULE Clinical Consulting / Care Management
• MOEDULE Customized QNXTâ„•¢ User Training
• MOEDULE Post-Implementation Audits
• MOEDULE Electronic data interchange
• MOEDULE Benefits & Contracts
• MOEDULE Subscriber / Member
• MOEDULE QNXTâ„•¢ Case Management
• MOEDULE Accounting, Billing & Commissions
• MOEDULE QNXTâ„•¢ Accounts Receivable
• MOEDULE Capitation
• MOEDULE Prior Authorization
• MOEDULE Provider
• MOEDULE Plan / Products
• MOEDULE Business Rules and Workflow
• MOEDULE Claims
• MOEDULE Customer Service
• MOEDULE QNXTâ„•¢ ITS (Interplan Teleprocessing System)
• MOEDULE QNXTâ„•¢ Dental

Why Us

Job oriented program

The course is focused on fetching you a job. It is designed by expert and experienced QA professionals. It gives you enough theory and practical aspect that is required to get QA’s job

No Pre-requisites

All those who are craving for a career in IT field can apply for this course irrespective of what the background is

Confidence

With us you get an opportunity to work on real time experience along with the expert trainer that will boost your confidence. It is going to help you at the time of interview when you will be asked to give examples

Hands on Training on Multiple Industry Tools

We are equipped with latest tools that most of the companies use today

Resume Preparation

As slated above, the sole objective of this course is to get you a job. We work on your resume and curtail it isaccording to job resume so that you can land up with the right job

Mock-up Interviews

Mock interview sessions by creating interviewee-interviewer scenario will prepare you deal with the actual interview

Job Marketing

We have a strong and widespread network of recruiters spread across the country who help you fetch job once you are ready to make a stride towards getting the job.

Rejoin the Course

If at any given point of time you wish to rejoin the course, you are more than welcome. Whether you want to brush up your knowledge on a particular aspect of training or some of your concepts are not clear, you can join it again

On Job support

We provide technical assistance for six months. So, if you have any query even while working you can always get back to us

Role specific Training

We provide technical assistance for six months. So, if you have any query even while working you can always get back to us. By contrast, ELearningLine'sseries of role-based courses delivers in-depth training on a specific role within the business process

Real Time Project Experience and Case Studies

ELearningLinecontinues to offer new courses so you can keep up-to-date on latest technologies and best practices.

Role specific Training

ELearningLinecontinues to offer new courses so you can keep up-to-date on latest technologies and best practices.

After reviewing your goals, and assessing your current IT skills capability, we will mold an after-the-training program and placement plan that will meet your needs in successful placement. This includes Resume preparation assistance, Mock interviews (technical and project based), Soft Skills and On-the-job support.

Recruitment

Today’s business world is highly competitive. There are a lot of resource constraints in the business environment. This is why IT and health insurance businesses are constantly being challenged to meet the ever-growing demands. Due to these new changes, it is essential to recruit highly qualified and experienced IT experts who will add value to the company within a short period of time.

We have a Technology recruitment was created to fill all your IT positions with qualified professionals. This has to be done in the most effective way. We always match your requirements with highly qualified candidates. Our work is to optimize the relationship between the two parties. This is a sure way of achieving employee retention as well as cutting on talent acquisition costs.

We provide the following services in our IT recruitment department:

• Determining position requirements
• Candidates referrals
• Interview preparation
• Sourcing candidates
• Interview coordination
• Interview Follow-Up
• Assess and Qualify Candidates

ElearningLine Introduction:

FACETS:

QNXT: