Medicare Pricing Analyst — Hybrid/Remote

WPS Data Logistics, Inc.; Madison, Northern (WI, KY); Hybrid; USD 45,000 - 56,000; Full time

Benefits offered by this job

401(k) with company match

Health insurance

Dental insurance

Telehealth services

Paid time off

Job summary

WPS Data Logistics, Inc. in Madison, WI is seeking a Medicare Pricing Analyst to research complex Medicare pricing and reimbursement issues, ensuring accuracy in Medicare claims processing and coding guidelines.

The role supports CMS pricing updates, maintains pricing data, and collaborates with CMS, Shared System Maintainers, and MACs for timely claims payments. The position also reviews CMS pricing guidance, assists with testing and validation, maintains internal documentation, and supports

Qualifications

• Bachelor’s degree in Health System Information or related field.
• 1+ years of Medicare Part A/B claims processing experience.
• Knowledge of Medicare program operations and billing procedures.
• Proficient in downloading/installing CMS files (FISS/MCS).
• Strong analytical and problem-solving skills.
• Experience documenting Change Requests and related pricing TDLs.

Responsibilities

• Investigate CMS pricing changes and validate updates.
• Review Part A/B claims, pricing files, and release notes for accuracy.
• Respond to internal requests with CMS-related pricing guidance.
• Monitor pricing disclosures and CMS articles for compliance.
• Document CMS changes and perform regular testing of pricing systems.
• Collaborate with CMS and Shared System Maintainers to implement system changes.

Skills

Medicare pricing & billing

Medicare Part A & B processing

Analytical thinking

Documentation & change requests

Education

Bachelor’s degree in Health System Information

Tools

FISS/MCS pricing files

Job description

WPS Data Logistics, Inc. in Madison, WI is seeking a Medicare Pricing Analyst to research complex Medicare pricing and reimbursement issues, ensuring accuracy in Medicare claims processing and coding guidelines.

The role supports CMS pricing updates, maintains pricing data, and collaborates with CMS, Shared System Maintainers, and MACs for timely claims payments. The position also reviews CMS pricing guidance, assists with testing and validation, maintains internal documentation, and supports