Job Abstract

Provider Pricing Analyst The Contract Analyst is a member of a cross functional team of business experts tasked to work independently and collectively to manage the professional and institutional reimbursement of contractual language for medical and dental provider contracts. The analyst will play a key role in contract methodologies, analyzing requirements, pricing, and validating the configuration with the Business owners to ensure requirements and quality goals are met. Provides analysis and ... more details

Provider Pricing Analyst The Contract Analyst is a member of a cross functional team of business experts tasked to work independently and collectively to manage the professional and institutional reimbursement of contractual language for medical and dental provider contracts. The analyst will play a key role in contract methodologies, analyzing requirements, pricing, and validating the configuration with the Business owners to ensure requirements and quality goals are met. Provides analysis and documentation that supports pricing requirements for accurate reimbursement allowances. Provides pricing analyzed for claims in accordance to the contract reimbursement language. Interpreting medical/insurance codes such for procedure and diagnosis. Support testing and audit requirements. Update customer specific documentation and reference materials. Participates in meetings to support decision making, enhancements, problem solving and process improvement. Answers inquiries from clients, claims and customer service. Contributes towards daily departmental performance and service level guarantees and achieves individual performance goals around accuracy and timeliness. Strong understanding of pricing methodologies for insurance claims. 3-5 years of experience in insurance industry. Strong CPT/HCPCS Procedure code, revenue code and ICD 10 knowledge. High aptitude for working with numbers. Ability to coordinate activities with team members. Ability to multi-task, adapt to change, manage shifting priorities and meet timelines. Possesses excellent interpersonal and communication skills. Detailed knowledge of all medical claim coding requirements. Strong attention to detail, analytical skills and problem-solving skills. Must have solid work ethic and positive demeanor. Strong computer knowledge. Efficient with Microsoft Office products.