Pricing Configuration Specialist

Menlo Ventures; Deutschland; Remote; EUR 60.000 - 80.000; Vollzeit

Zusammenfassung

A healthcare technology company in Germany is seeking a Pricing Configuration Analyst to ensure accurate implementation and maintenance of claims databases. The role requires 3+ years of experience with PPS coding, excellent analytical skills, and strong communication abilities. You will work closely with cross-functional teams to ensure timely updates on system and pricing modules. Competitive salary, comprehensive benefits, and a chance to impact healthcare transformation are offered.

Leistungen

Competitive salary

Bonus opportunity

Comprehensive Medical, Dental, and Vision benefits

401k retirement plan

Paid vacation and company holidays

Qualifikationen

• 3+ years of experience with PPS coding, DRG Grouping & APC Payment methodology.
• Strong analytical skills with the ability to interpret complex data.
• Ability to work independently and as part of a team in a fast-paced environment.

Aufgaben

• Coordinate and maintain all prospective payment system configuration.
• Serve as subject matter expert related to CMS pricing rules.
• Perform root cause analysis on claim and system issues.

Kenntnisse

PPS coding

Analytical skills

Experience with 3M, Optum

Communication skills

Knowledge of healthcare benefits

Ausbildung

Bachelor’s degree

Jobbeschreibung

About the Role

The Pricing Configuration Analyst plays a crucial role in ensuring the accurate and timely implementation and maintenance of critical information on our claims databases. This individual will work closely with cross-functional teams to ensure timely and accurate updates to system and pricing modules used for payment of claims.

What You'll Do

• Coordinate and maintain all prospective payment system (PPS) configuration and/or external system pricer/grouper upgrades

• Troubleshoot any coding/grouping issues as reported to determine appropriate assignment of DRG/APC

• Serve as subject matter expert related to CMS pricing rules and methodologies (MS-DRG, CMG, ASC PPS, IPF PPS, IRF PPS, Professional claims)

• Partner with training and documentation teams to build necessary training, policy and procedure documentation as it relates to implementation and use of external pricers/groupers and exception handling

• Perform root cause analysis on claim and system issues

• Partner with actuarial team on internal pricing methodology and updates

• Support claims production teams with regard to questions around both overall process and specific claim investigations

• Implement and maintain accurate and timely critical information on claims databases

• Remain current on all CMS pricing rules and regulations, coding updates, changes, and issues

• Interpret specific state and/or federal benefits, contracts, and additional business requirements, converting these terms to configuration parameters
• Code, update, and maintain provider contracts, fee schedules, and various system tables through the user interfaceand PPS systems

What You'll Bring

• 3+ years of experience with PPS coding, DRG Grouping & APC Payment methodology

• Bachelor’s degree

• Strong analytical skills with the ability to interpret complex data

• Experience working industry standard groupers (3M, Optum, etc)

• Knowledge of healthcare benefits, contracts, and fee schedules

• Excellent communication and interpersonal skills

• Ability to work independently and as part of a team in a fast-paced environment

What You'll Get

• Competitive salary, bonus opportunity, and equity package

• Comprehensive Medical, Dental, and Vision benefits

• A 401k retirement plan

• Paid vacation and company holidays

• Opportunity to make an impact at a rapidly growing mission-driven company transforming healthcare in the U.S

Sidecar Health is an Equal Opportunity employer committed to building a diverse team. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status or disability status.