Medicare Pricing Coordinator – Data & Rate Analysis

Health Care Service Corp.; Albuquerque (NM); On-site; USD 48,000 - 86,000; Full time

Job summary

Health Care Service Corporation seeks a candidate to provide technical direction in defining and implementing provider reimbursement rates based on CMS Medicare methodologies, mainly Part B. You will monitor pricing structures, evaluate impacts on IHs FI processes, and ensure current Medicare rates are loaded and available for pricing.

The role requires a math- or analytics-focused background, with experience in data analysis, healthcare finance, and strong verbal/written communication.

Qualifications

• Bachelor degree in Math, Statistics, or Computer Science OR 4 years experience in the health care industry.
• 1 year experience with databases such as Access and spreadsheets such as Excel.
• 1 year experience in a position that requires data analysis.
• Knowledge of healthcare finance and reimbursement methodologies, including provider contract execution.
• Verbal and written communication skills.
• Math skills.
• Self-starter with the ability to meet deadlines.

Responsibilities

• Provide technical direction on defining and implementing provider reimbursement rates for CMS Medicare Part B programs.
• Monitor the structure of Part B pricing procedures and evaluate impacts on IHs fiscal intermediary processes.
• Obtain current Medicare rates and ensure systems loaded with correct data.
• Distribute pricing information to staff for pricing use.

Skills

Data analysis

Communication skills

Math skills

Self-motivation

Education

Bachelor degree in Math, Statistics, or Computer Science

Tools

Access

Excel

Job description

Health Care Service Corporation seeks a candidate to provide technical direction in defining and implementing provider reimbursement rates based on CMS Medicare methodologies, mainly Part B. You will monitor pricing structures, evaluate impacts on IHs FI processes, and ensure current Medicare rates are loaded and available for pricing.

The role requires a math- or analytics-focused background, with experience in data analysis, healthcare finance, and strong verbal/written communication.