Healthcare Pricing Configuration Analyst - Remote

Overview

The Healthcare Pricing Configuration Analyst will leverage expertise in pricing configuration, Payer Compass software, and knowledge of Medicare, Medicaid, and commercial pricing to drive quality and configure pricing models within the healthcare payer environment.

In Short

• Develop and maintain pricing configuration models for various payer categories.
• Configure pricing systems for accurate reimbursement and compliance.
• Collaborate with teams to implement system changes and updates.
• Analyze and resolve pricing discrepancies.
• Utilize Payer Compass for pricing system configuration.
• Apply knowledge of Medicare, Medicaid, and commercial payer systems.
• Conduct testing of pricing configurations for accuracy and compliance.
• Communicate pricing changes and system updates effectively.
• Maintain documentation on pricing configurations and system settings.
• Assist in audit preparation and regulatory reporting.

Requirements

• 8+ years of pricing configuration experience.
• 5+ years working with Payer Compass software preferred.
• Knowledge of healthcare industry, medical terminology, and claims processing.
• Experience with CMS regulations and pricing methodologies.
• Proven experience in quality assurance and configuration management.
• Intermediate to advanced SQL Server Management Studio knowledge.
• Excellent problem-solving skills and attention to detail.
• Strong communication and interpersonal skills.

Benefits

• Opportunity to work in a people-first environment.
• Engagement in meaningful work that impacts healthcare.
• Collaboration with cross-functional teams.
• Continuous learning and professional development opportunities.
• Flexible working arrangements.