Hospital Price Transparency Analyst

Med Metrix•Parsippany-Troy Hills, NJ

About The Position

The Hospital Price Transparency Analyst maintains and optimizes automated processes and a proprietary rule engine for a pricing transparency tool. The role includes analyzing hospital claims data, auditing results for data integrity, resolving identified data issues, and helping ensure the product complies with current industry regulations and code sets. The analyst produces client-friendly price index reports after confirming data integrity, contributes to product enhancements by defining acceptance criteria and translating user requirements into compliant designs, and tests development work for accuracy and consistency with specifications. The role also answers questions from internal teams and clients, attends virtual client meetings to review files and discuss client datasets, monitors regulatory and code changes, and provides industry expertise to support other departments and improve the client experience. The position requires handling protected health information only in accordance with HIPAA standards and following Information Security and HIPAA policies. Access to PHI must be limited to the minimum necessary to perform assigned duties. The work environment is usually minimally noisy. A smartphone or other electronic device capable of downloading applications is required for multifactor authentication and security purposes.

Requirements

High school diploma or equivalent.
Minimum of 5 years of combined inpatient/outpatient coding and/or billing experience in a healthcare environment.
Advanced awareness and understanding of government regulations and resources affecting hospital price transparency rules.
Practical knowledge of healthcare provider business processes, including clinical coding, chargemaster management, charge capture, billing, and/or charge reconciliation.
Ability to consistently interpret and apply official regulatory guidelines to real-world scenarios.
Proficiency in Microsoft Office Suite, with strong Excel skills.
Strong interpersonal skills and ability to communicate well at all levels of the organization.
Strong problem-solving and creative skills, sound judgment, and ability to make decisions based on accurate and timely analyses.
High integrity and dependability, with a strong sense of urgency and results orientation.
Excellent written and verbal communication skills.
Smartphone or other electronic device capable of downloading applications for multifactor authentication and security purposes.
Ability to follow directions, collaborate with others, and handle stress.

Nice To Haves

Active coding certification from the American Health Information Management Association (AHIMA) or the American Academy of Professional Coders (AAPC).

Responsibilities

Maintain the proprietary pricing transparency tool to ensure compliance with current regulations and code sets.
Audit price index results after data parsing and work with the development team to resolve identified data issues.
Create client-friendly price index reports after confirming data integrity.
Evaluate and participate in developing product enhancements, including defining acceptance criteria and translating user-level requirements into a logical design that meets compliance requirements.
Test development work to ensure accuracy and consistency with product specifications.
Answer product questions from project management, product implementation consultants, marketing, sales teams, and clients.
Attend virtual client meetings to review files and discuss questions related to client datasets.
Monitor regulatory requirements and code changes and apply them to maintain the integrity of the pricing transparency product.
Provide relevant input and industry expertise to other departments to optimize the client experience.
Use, protect, and disclose patients’ protected health information only in accordance with HIPAA standards.
Comply with Information Security and HIPAA policies and procedures, limiting PHI access to the minimum necessary.