Hybrid Pricing & Reimbursement Analyst I/II

Cambia Health Solutions, Inc.; Portland (OR); Hybrid; USD 59,000 - 79,000; Full time

Benefits offered by this job

Hybrid work model

Job summary

Cambia Health Solutions, Inc. seeks a Pricing and Reimbursement Analyst I or II to join a hybrid team working from multiple offices. Expect duties across contract payments, rate maintenance, and reimbursement methodologies for providers, with opportunities for leadership on corporate projects.

Role requires strong data translation, analytical skills, and proficiency in Excel and SQL. Salary varies by location; relocation may be needed for some candidates.

Qualifications

• Bachelor’s degree in business or related field and health care industry experience.
• At least two years experience in health care and one year project related experience.
• Analytical ability to identify problems and develop solutions.

Responsibilities

• Collaborate with Provider Services, Network Management, and operations staff to ensure payments are implemented correctly.
• Load and maintain rates in system files to price claims for contracted providers.
• Research and implement provider reimbursement methodologies industry-wide.
• Create payment exhibits attached to provider contracts and maintain CPT, DRG, HCPCS coding changes.
• Research contract and pricing issues to prevent over/underpayments and coordinate solutions.

Skills

Read contracts & pricing

Pricing methodologies

Analytical ability

Communication skills

SQL query development

Education

Bachelor's degree in business or related field

Tools

SQL

Microsoft Excel

Job description

Cambia Health Solutions, Inc. seeks a Pricing and Reimbursement Analyst I or II to join a hybrid team working from multiple offices. Expect duties across contract payments, rate maintenance, and reimbursement methodologies for providers, with opportunities for leadership on corporate projects.

Role requires strong data translation, analytical skills, and proficiency in Excel and SQL. Salary varies by location; relocation may be needed for some candidates.