Pricing Coordinator

Health Care Service Corporation • Albuquerque, NM

2d • $41,700 - $92,800 • Onsite

About The Position

This Position Is Responsible For Providing Technical Direction On Defining And Implementing Provider Reimbursement Rates Based On Center For Medicare And Medicaid Services (Cms) Medicare Methodologies, Primarily In The Part B Programs.. Monitoring The Structure Of And Changes To The Medicare Part B Pricing Procedures And Evaluating The Impact On Indian Health Service (Ihs) Fiscal Intermediary (Fi) Processes; Informing Management Of The Implications And Making Recommendations As Appropriate. Obtaining Current Medicare Rates, Working With Systems To Have Them Loaded, And/Or Distributing The Information To Staff To Use In Pricing.

Requirements

• Bachelor degree in Math, Statistics, or Computer Science OR 4 years experience in the health care industry
• 1 year experience with databases such as Access and spreadsheets such as Excel.
• 1 year experience in a position that requires data analysis.
• Knowledge of healthcare finance and reimbursement methodologies, including provider contract execution.
• Verbal and written communication skills.
• Math skills.
• Self-starter with the ability to meet deadlines.

Nice To Haves

• Familiarity with research techniques.
• Knowledge of Medicare and Medicaid reimbursement methodologies and private insurance reimbursement, claims processing concepts, and medical classification coding systems.
• Experience developing and evaluating reimbursement methodologies.
• Experience with PC, mainframe applications and encoding systems.
• Claims processing experience.

Responsibilities

• Providing technical direction on defining and implementing provider reimbursement rates based on CMS Medicare methodologies, primarily in Part B programs.
• Monitoring the structure of and changes to Medicare Part B pricing procedures.
• Evaluating the impact of Medicare Part B pricing procedures on IHS fiscal intermediary processes.
• Informing management of implications and making recommendations.
• Obtaining current Medicare rates.
• Working with systems to have Medicare rates loaded.
• Distributing Medicare rate information to staff for pricing.

Benefits

• Health and wellness benefits
• 401(k) savings plan
• Pension plan
• Paid time off
• Paid parental leave
• Disability insurance
• Supplemental life insurance
• Employee assistance program
• Paid holidays
• Tuition reimbursement

What This Job Offers

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