Hospital Price Transparency Analyst

Med-Metrix; Parsippany-Troy Hills (NJ); On-site; USD 65,000 - 90,000; Full time

Job summary

Med-Metrix is seeking a Hospital Price Transparency Analyst in New Jersey to maintain and optimize a proprietary pricing tool. You will audit price index results, ensure data integrity, and collaborate with the development team to resolve issues while ensuring regulatory compliance.

The role requires at least 5 years of coding/billing experience in healthcare, familiarity with AHIMA/AAPC certifications, and strong Excel skills.

Qualifications

• Minimum of 5 years inpatient/outpatient combined coding and/or billing experience in a healthcare environment.
• Active coding certification from AHIMA or AAPC is preferred.
• Strong understanding of government regulations impacting hospital price transparency rules.
• Proficiency in Microsoft Office Suite, especially Excel.
• Excellent written and verbal communication skills.

Responsibilities

• Maintain proprietary pricing transparency tool to ensure compliance with current regulations.
• Audit price index results after data parsing and resolve data issues with the development team.
• Create price index reports in client-friendly format after confirming data integrity.
• Participate in development of future product enhancements and define acceptance criteria.
• Test development work to ensure accuracy and alignment with product specifications.
• Answer product questions from project management, implementation, marketing and sales teams, plus clients.
• Attend virtual meetings with clients to review files and dataset-specific questions.
• Stay updated on evolving regulatory requirements and apply them to maintain data integrity.
• Support other departments with input to optimize the client experience.
• Perform other duties as assigned.
• Uphold HIPAA standards and protect PHI.

Skills

Healthcare data analysis

Regulatory compliance

Excel proficiency

Communication skills

HIPAA awareness

Tools

Microsoft Excel

Billing systems

Job description

Job Purpose

The Hospital Price Transparency Analyst will work to maintain and optimize automated processes related to the pricing transparency tool, including but not limited to, analyzing hospital claims data, auditing the results for data integrity, and resolving identified data issues. The Hospital Price Transparency Analyst will also be responsible for maintaining and optimizing the proprietary rule engine to ensure optimal client experience and compliance with current industry regulations.

Duties & Responsibilities

• Maintain established proprietary pricing transparency tool to ensure that product is compliant with current regulations and code sets
• Audit price index results after data parsing and work with the development team to resolve any identified data issues
• Create price index reports in a client-friendly format following confirmation of data integrity
• Evaluates the need for and participates in the development of future product enhancements, including defining acceptance criteria and translating user-level requirements into a logical design that meets compliance requirements.
• Tests development work to assure accuracy and consistency with product specifications
• Answer product questions from project management, product implementation consultants, marketing, and sales teams in addition to client questions
• Attend virtual meetings with clients to review files and ask/address questions relating to the client's specific dataset
• Stay abreast of evolving regulatory requirements and code changes; apply this information appropriately to ensure integrity of the pricing transparency product
• Support other departments by providing relevant input and industry expertise to optimize the client experience
• Other duties as assigned
• Use, protect and disclose patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards

• Understand and comply with Information Security and HIPAA policies and procedures at all times
• Limit viewing of PHI to the absolute minimum as necessary to perform assigned duties

Qualifications

• High-school diploma or equivalent required
• Minimum of 5 years inpatient/outpatient combined coding and/or billing experience in a healthcare environment
• Active coding certification from the American Health Information Management Association (AHIMA) or the American Academy of Professional Coders (AAPC) is preferred
• Advanced awareness and understanding of government regulations and resources impacting hospital price transparency rules
• Practical knowledge of healthcare provider business processes including clinical coding, chargemaster management, charge capture, billing and/or charge reconciliation
• Able to consistently interpret and apply official regulatory guidelines to real-world scenarios
• Proficiency in Microsoft Office Suite, with strong Excel skills
• Strong interpersonal skills, ability to communicate well at all levels of the organization
• Strong problem solving and creative skills and the ability to exercise sound judgment and make decisions based on accurate and timely analyses
• High level of integrity and dependability with a strong sense of urgency and results oriented
• Excellent written and verbal communication skills required

Working Conditions

• Must possess a smart-phone or electronic device capable of downloading applications, for multifactor authentication and security purposes
• Physical Demands: While performing the duties of this job, the employee is occasionally required to move around the work area; Sit; perform manual tasks; operate tools and other office equipment such as computer, computer peripherals and telephones; extend arms; kneel; talk and hear
• Mental Demands: The employee must be able to follow directions, collaborate with others, and handle stress
• Work Environment: The noise level in the work environment is usually minimal

Med-Metrix will not discriminate against any employee or applicant for employment because of race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, genetic information (including family medical history), political affiliation, military service, veteran status, other non-merit based factors, or any other characteristic protected by federal, state or local law.