Medicare Pricing Analyst — Remote/Hybrid

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

Benefits offered by this job

Remote/hybrid options

Performance bonus

401(k) with match

Paid time off

Health & dental insurance

Telehealth

Leadership development

Job summary

WPS in the United States seeks a Medicare Pricing Analyst to research complex Medicare pricing and reimbursement issues, validate CMS updates, and ensure accurate claims processing and coding guidelines. This role collaborates with CMS, Shared System Maintainers and MACs to ensure timely payments.

The position offers remote/hybrid options and requires 1+ years in Medicare pricing or claims processing, with strong analytical and documentation skills to support CMS pricing operations.

Qualifications

• Bachelor’s degree or equivalent combination of education and experience.
• 1+ years of Medicare Part A and Part B claims processing experience.
• Knowledge of Medicare program and operations, including billing procedures.
• Proficient in downloading/installing CMS files (FISS/MCS).
• Strong analytical and organizational skills.
• Ability to coordinate documentation for Change Requests and TDLs.

Responsibilities

• Implement changes to CMS systems, validate, test, and install updates.
• Review Part A and Part B claims for proper processing and payments.
• Source pricing information from Redbook and CMS resources.
• Respond to OnBase requests with CMS and Shared System Maintainers resources.
• Review pricing articles for CMS guideline compliance.
• Maintain detailed records of CMS changes and perform testing/validation.

Skills

Medicare pricing knowledge

Claims processing

Analytical skills

Documentation

Project collaboration

Problem-solving

Education

Bachelor’s degree in Health System Information

Tools

FISS/MCS pricing files

OnBase

CMS resources

Job description

WPS in the United States seeks a Medicare Pricing Analyst to research complex Medicare pricing and reimbursement issues, validate CMS updates, and ensure accurate claims processing and coding guidelines. This role collaborates with CMS, Shared System Maintainers and MACs to ensure timely payments.

The position offers remote/hybrid options and requires 1+ years in Medicare pricing or claims processing, with strong analytical and documentation skills to support CMS pricing operations.