Hospital Price Transparency Analyst

Med Metrix•Parsippany-Troy Hills, NJ

6d•Onsite

About The Position

The Hospital Price Transparency Analyst will work to maintain and optimize automated processes related to the pricing transparency tool, including but not limited to, analyzing hospital claims data, auditing the results for data integrity, and resolving identified data issues. The Hospital Price Transparency Analyst will also be responsible for maintaining and optimizing the proprietary rule engine to ensure optimal client experience and compliance with current industry regulations.

Requirements

High-school diploma or equivalent required
Minimum of 5 years inpatient/outpatient combined coding and/or billing experience in a healthcare environment
Advanced awareness and understanding of government regulations and resources impacting hospital price transparency rules
Practical knowledge of healthcare provider business processes including clinical coding, chargemaster management, charge capture, billing and/or charge reconciliation
Able to consistently interpret and apply official regulatory guidelines to real-world scenarios
Proficiency in Microsoft Office Suite, with strong Excel skills
Strong interpersonal skills, ability to communicate well at all levels of the organization
Strong problem solving and creative skills and the ability to exercise sound judgment and make decisions based on accurate and timely analyses
High level of integrity and dependability with a strong sense of urgency and results oriented
Excellent written and verbal communication skills required

Nice To Haves

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

Responsibilities

Maintain established proprietary pricing transparency tool to ensure that product is compliant with current regulations and code sets
Audit price index results after data parsing and work with the development team to resolve any identified data issues
Create price index reports in a client-friendly format following confirmation of data integrity
Evaluates the need for and participates in the development of future product enhancements, including defining acceptance criteria and translating user-level requirements into a logical design that meets compliance requirements.
Tests development work to assure accuracy and consistency with product specifications
Answer product questions from project management, product implementation consultants, marketing, and sales teams in addition to client questions
Attend virtual meetings with clients to review files and ask/address questions relating to the client's specific dataset
Stay abreast of evolving regulatory requirements and code changes; apply this information appropriately to ensure integrity of the pricing transparency product
Support other departments by providing relevant input and industry expertise to optimize the client experience
Other duties as assigned
Use, protect and disclose patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards
Understand and comply with Information Security and HIPAA policies and procedures at all times
Limit viewing of PHI to the absolute minimum as necessary to perform assigned duties