Hospital Price Transparency Analyst

Med-Metrix•Parsippany-Troy Hills, NJ

About The Position

The Hospital Price Transparency Analyst maintains and optimizes automated processes for the pricing transparency tool. The role includes analyzing hospital claims data, auditing results for data integrity, resolving data issues, and maintaining the proprietary rule engine to support a positive client experience and compliance with current industry regulations. The analyst also develops client-friendly price index reports, supports product enhancements and testing, answers questions from internal teams and clients, and keeps current with regulatory and code changes. The position requires handling protected health information in accordance with HIPAA and following Information Security and HIPAA policies. Access to PHI must be limited to the minimum necessary to perform assigned duties.

Requirements

High-school diploma or equivalent.
At least 5 years of combined inpatient/outpatient coding and/or billing experience in a healthcare environment.
Advanced awareness and understanding of government regulations and resources that affect 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 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, a strong sense of urgency, and a results-oriented approach.
Excellent written and verbal communication skills.
Must possess a 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 the need for and participate in product enhancements, including defining acceptance criteria and translating user-level requirements into a logical design that meets compliance requirements.
Test development work for 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 relating to the client's dataset.
Stay current with 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.
Perform other duties as assigned.
Use, protect, and disclose patients' protected health information only in accordance with HIPAA standards.
Comply with Information Security and HIPAA policies and procedures and limit PHI access to the minimum necessary.