Medicare Pricing & Reimbursement Analyst

hcsc; Albuquerque (NM); On-site; USD 42,000 - 93,000; Full time

Job summary

Health Care Service Corporation (HCSC) is seeking a position responsible for directing the definition and implementation of CMS Medicare Part B reimbursement methodologies. The role involves monitoring pricing procedures, evaluating impacts on FI processes, and ensuring Medicare rates are current and loaded into pricing systems.

The ideal candidate will have a math/statistics/computer science background or equivalent healthcare industry experience, plus data analysis and Excel/database skills,

Qualifications

• Bachelor's degree in Math, Statistics, or Computer Science, or 4 years in health care.
• 1 year experience with databases (Access) and spreadsheets (Excel).
• 1 year experience in data analysis.
• Knowledge of healthcare finance and reimbursement methodologies.

Responsibilities

• Provide technical direction on defining and implementing CMS Medicare Part B pricing methodologies.
• Monitor Medicare Part B pricing procedures and their impact on Indian Health Service FI processes.
• Inform management of implications and recommendations as appropriate.
• Obtain current Medicare rates and ensure systems are loaded correctly for pricing.

Skills

Math/Stats/CS degree

Healthcare industry experience

Data analysis experience

Database skills (Access)

Excel skills

Verbal & written communication

Self-starter, deadline driven

Education

Bachelor's degree in Math/Statistics/CS

Job description

Health Care Service Corporation (HCSC) is seeking a position responsible for directing the definition and implementation of CMS Medicare Part B reimbursement methodologies. The role involves monitoring pricing procedures, evaluating impacts on FI processes, and ensuring Medicare rates are current and loaded into pricing systems.

The ideal candidate will have a math/statistics/computer science background or equivalent healthcare industry experience, plus data analysis and Excel/database skills,