Medicare IT Analyst - Pricing Procedures Analyst

WPS—A health solutions company • Fitchburg, WI

1d • Remote

About The Position

Our Medicare IT Analyst - Pricing Procedures Analyst is responsible for
researching and responding to interdepartmental referrals while ensuring the
accuracy and effectiveness of processing and coding guidelines. This Medicare IT
Analyst plays a pivotal role supporting internal technology, and systems and
will maintain internal manuals, coordinate updates to pricing files in systems
like MCS and FISS, and request changes for Pricing File Updates. The Pricing
Procedures Analyst requires active participation in weekly Functional Workgroup
(FWG) calls and collaboration with other MACs and CMS. Additionally, they
support document maintenance and assist the Technical Claims team with various
projects and assignments.

Requirements

• Bachelor’s degree in Health System Information or a related discipline, or equivalent combination of education and experience.
• 1 or more years of experience in Medicare Part A and Part B claims processing.
• Knowledge of Medicare program and operations, as well as a thorough understanding of claims processing and billing procedures.
• Proficient in navigating systems and/or applications to effectively download and install files (i.e., FISS/MCS pricing files).
• Strong analytical skills and problem-solving skills.
• Demonstrated organizational skills with ability to coordinate and maintain detailed documentation for the implementation of Change Requests and TDLs related to pricing.
• Ability to collaborate effectively and provide support to the Technical Claims team with various projects and assignments as needed.

Nice To Haves

• Experience performing yearly Profile Builds related to pricing functions in MCS and FISS.

Responsibilities

• Researching and responding to interdepartmental referrals while ensuring the accuracy and effectiveness of processing and coding guidelines.
• Maintaining internal manuals.
• Coordinating updates to pricing files in systems like MCS and FISS.
• Requesting changes for Pricing File Updates.
• Active participation in weekly Functional Workgroup (FWG) calls and collaboration with other MACs and CMS.
• Supporting document maintenance.
• Assisting the Technical Claims team with various projects and assignments.

Benefits

• Remote and hybrid work options available
• Performance bonus and/or merit increase opportunities
• 401(k) with a 100% match for the first 3% of your salary and a 50% match for the next 2% of your salary (100% vested immediately)
• Competitive paid time off
• Health insurance, dental insurance, and telehealth services start DAY 1
• Professional and Leadership Development Programs

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level