Medicare Pricing Analyst — Remote/Hybrid

WPS—A health solutions company; Town of Texas (WI); Hybrid; USD 45,000 - 56,000; Full time

Benefits offered by this job

Remote/hybrid options

Bonus opportunities

401(k) match

Paid time off

Health insurance

Dental insurance

Telehealth

Leadership development

Job summary

WPS Health Solutions is seeking a Medicare Pricing Analyst in Madison, WI. You will research Medicare pricing and reimbursement issues, support CMS pricing updates, and maintain pricing information across Medicare systems.

The role collaborates with CMS, Shared System Maintainers, and MACs to ensure accurate claims payment. Responsibilities include responding to interdepartmental requests, system testing, and maintaining internal documentation.

Qualifications

• Requires Bachelor’s degree in health information or related field.
• 1+ year of Medicare Part A/B claims processing experience.
• Knowledge of Medicare program and billing procedures.
• Ability to download/install pricing files and use CMS resources.

Responsibilities

• Implement CMS system changes and validate updates.
• Review Part A/B claims, apply processing guidelines and pricing rules.
• Respond to pricing requests using CMS and Shared System Maintainers resources.
• Analyze Fee Schedule Disclosures and pricing articles for CMS compliance.
• Maintain documentation of CMS changes and test pricing systems.
• Collaborate with CMS and Shared System Maintainers on system changes.

Skills

Analytical reasoning

Problem solving

Organizational skills

Collaboration

Education

Bachelor’s degree in Health System Information or related

Tools

FISS/MCS pricing files

Job description

WPS Health Solutions is seeking a Medicare Pricing Analyst in Madison, WI. You will research Medicare pricing and reimbursement issues, support CMS pricing updates, and maintain pricing information across Medicare systems.

The role collaborates with CMS, Shared System Maintainers, and MACs to ensure accurate claims payment. Responsibilities include responding to interdepartmental requests, system testing, and maintaining internal documentation.