Contract Pricing Specialist

St. Luke's Hospital - MO•Chesterfield, MO

10d•Onsite

About The Position

The Contract Pricing Specialist is responsible for ensuring accurate interpretation, implementation, and maintenance of managed care or government contract terms within St. Luke’s Hospital pricing, billing, and reimbursement systems. This role plays a key part in supporting revenue integrity by validating expected reimbursement, analyzing variances and payer trends to optimize payer performance and revenue capture. Responsible for promoting teamwork with all members of the healthcare team. Performs duties in a manner consistent with St. Luke’s mission and values.

Requirements

Experience in healthcare revenue cycle, managed care contracting, reimbursement analysis, or financial analytics required.
Proficiency in healthcare billing systems and/or denial management software, including experience with medical and insurance terminology and billing forms.
Strong analytical skills and ability to translate data into measurable action.
Ability to effectively present projects to management for evaluation and prioritization.
Strong skills in process improvement, business transformation, customer service, communication, leadership, problem solving and team building.
Ability to maintain effectiveness and professionalism when experiencing change in work tasks and/or the work environment.

Nice To Haves

Bachelor’s degree preferred with focus in Healthcare Administration, Business or related field preferred.
Certified Revenue Cycle Representative (CRCR) or similar certification preferred.

Responsibilities

Ensuring accurate interpretation, implementation, and maintenance of managed care or government contract terms within St. Luke’s Hospital pricing, billing, and reimbursement systems.
Supporting revenue integrity by validating expected reimbursement.
Analyzing variances and payer trends to optimize payer performance and revenue capture.
Promoting teamwork with all members of the healthcare team.
Performing duties in a manner consistent with St. Luke’s mission and values.