Medicare Pricing Analyst - Remote & Hybrid Eligible

Wis Phys Svc Ins Corp; Madison (WI); Hybrid; USD 45,000 - 56,000; Full time

Benefits offered by this job

Performance bonus

401(k) with match

Health insurance

Dental insurance

Telehealth

Job summary

Wis Phys Svc Ins Corp in Madison, WI is seeking a Medicare Pricing Analyst to research complex pricing and reimbursement issues, ensuring accuracy in claims processing and coding guidelines. The role supports CMS pricing updates, maintains pricing data, and collaborates with CMS and MACs to ensure timely payments.

The position requires a bachelor’s degree in health information, 1+ years in Medicare claims processing, and strong analytical skills.

Qualifications

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

Responsibilities

• Researches complex Medicare pricing and reimbursement issues and supports CMS pricing updates.
• Maintains pricing information within Medicare systems and validates system changes.
• Collaborates with CMS, Shared System Maintainers, and other MACs to ensure accurate claims payment.
• Responds to interdepartmental requests and reviews pricing guidance; supports testing/validation.
• Maintains internal documentation and supports the Technical Claims team on pricing projects.

Skills

Analytical thinking

Problem-solving

Collaboration

Organizational skills

Education

Bachelor’s degree in Health System Information

Tools

FISS

MCS

Job description

Wis Phys Svc Ins Corp in Madison, WI is seeking a Medicare Pricing Analyst to research complex pricing and reimbursement issues, ensuring accuracy in claims processing and coding guidelines. The role supports CMS pricing updates, maintains pricing data, and collaborates with CMS and MACs to ensure timely payments.

The position requires a bachelor’s degree in health information, 1+ years in Medicare claims processing, and strong analytical skills.