Medicare Pricing & Claims Analyst - Hybrid/Remote

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

Benefits offered by this job

Remote/hybrid work options

Performance bonus

401(k) match

Competitive paid time off

Health/dental/telehealth from day 1

Leadership development programs

Benefits overview link

Job summary

WPS, a health solutions company, is seeking a Medicare Pricing Analyst to research complex pricing, support CMS updates, and ensure accurate claims processing and coding guidelines. The role collaborates with CMS and MACs to validate pricing and drive timely payments.

The position involves handling pricing requests, maintaining CMS-related records, and participating in system testing and validation to improve pricing operations across the organization.

Qualifications

• Bachelor’s degree or equivalent in health information or related field.
• 1+ year Medicare Part A/B claims processing experience.
• Strong analytical and organizational skills.

Responsibilities

• Research and resolve complex Medicare pricing and reimbursement issues.
• Support CMS pricing updates, updates validation, and testing.
• Respond to interdepartmental pricing requests using CMS resources.
• Maintain documentation of CMS changes and pricing updates.
• Collaborate with CMS and Shared System Maintainers to enhance pricing systems.

Skills

Medicare pricing

CMS knowledge

Data analysis

Pricing files

Education

Bachelor’s degree in health information or related field

Tools

OnBase

CMS systems

Job description

WPS, a health solutions company, is seeking a Medicare Pricing Analyst to research complex pricing, support CMS updates, and ensure accurate claims processing and coding guidelines. The role collaborates with CMS and MACs to validate pricing and drive timely payments.

The position involves handling pricing requests, maintaining CMS-related records, and participating in system testing and validation to improve pricing operations across the organization.