Medicare Pricing Analyst (Hybrid/Remote)

WPS—A health solutions company; Michigan; Hybrid; USD 45,000 - 56,000; Full time

Benefits offered by this job

Remote and hybrid work options

Job summary

WPS—A health solutions company in the United States is seeking a Medicare Pricing Analyst to research complex pricing and reimbursement issues and ensure accurate claims processing and coding guidelines. The role supports CMS pricing updates, maintains pricing information, and collaborates with CMS, Shared System Maintainers, and MACs to ensure timely payments.

Responsibilities include responding to interdepartmental requests, reviewing pricing guidance, and assisting the Technical Claims team

Qualifications

• Bachelor’s degree or equivalent in Health System Information or related field.
• 1+ years of experience in Medicare Part A and Part B claims processing.
• Strong knowledge of Medicare program operations and billing procedures.
• Proficient in downloading/installing CMS pricing files (FISS/MCS).
• Demonstrated organizational skills and ability to document changes.

Responsibilities

• Research complex Medicare pricing and reimbursement issues with accuracy.
• Support CMS pricing updates and validation within Medicare systems.
• Collaborate with CMS, Shared System Maintainers, and MACs to ensure timely payments.
• Respond to interdepartmental requests and maintain internal pricing docs.
• Assist Technical Claims with projects to improve pricing accuracy and efficiency.

Skills

Analytical skills

Problem-solving

Documentation

Collaboration

Pricing knowledge

Systems navigation

Education

Bachelor’s degree in Health System Information

Tools

FISS/MCS pricing files

Job description

WPS—A health solutions company in the United States is seeking a Medicare Pricing Analyst to research complex pricing and reimbursement issues and ensure accurate claims processing and coding guidelines. The role supports CMS pricing updates, maintains pricing information, and collaborates with CMS, Shared System Maintainers, and MACs to ensure timely payments.

Responsibilities include responding to interdepartmental requests, reviewing pricing guidance, and assisting the Technical Claims team