NetworX Configuration Analyst

Themesoft Inc; United States; On-site; USD 90,000 - 130,000; Full time

Job summary

Themesoft Inc. is seeking a NetworX Configuration Analyst to support provider contract pricing, reimbursement configuration, and claims adjudication within the NetworX Pricing platform.

The ideal candidate will have strong healthcare payer experience and expertise in NetworX and FACETS to translate provider contract requirements into accurate pricing configurations. The role involves configuring contracts and fee schedules, analyzing requirements, performing validation, and collaborating with

Qualifications

• Experience configuring provider contracts, fee schedules, and reimbursement methods.
• Knowledge of NetworX pricing configurations and pricing validation processes.
• Experience with claims adjudication and reimbursement workflows.

Responsibilities

• Configure and maintain provider contracts, fee schedules, qualifier groups, and reimbursement methodologies in NetworX.
• Analyze business and contractual requirements and translate them into system configurations.
• Perform pricing validation, claims analysis, testing, and production support.
• Investigate and resolve pricing, reimbursement, and claims adjudication issues.
• Collaborate with Provider Contracting, Claims, Business, and IT teams to implement configuration changes.
• Support UAT, production releases, and post-implementation validation activities.
• Create and maintain configuration documentation and testing evidence.

Skills

NetworX Pricing

NetworX Modeler

FACETS

Job description

1. NetworX Pricer and NetworX Modeler experience.
2. Provider contract and reimbursement configuration experience. Experience with fee schedules, pricing methodologies, and network reimbursement.
3. FACETS configuration and claims adjudication knowledge.

Job Summary

We are seeking a NetworX Configuration Analyst to support provider contract pricing, reimbursement configuration, and claims adjudication within the NetworX Pricing platform. The ideal candidate will have strong healthcare payer experience, expertise in NetworX and FACETS, and the ability to translate provider contract requirements into accurate pricing configurations.

Key Responsibilities

• Configure and maintain provider contracts, fee schedules, qualifier groups, and reimbursement methodologies in NetworX.
• Analyze business and contractual requirements and convert them into system configurations.
• Perform pricing validation, claims analysis, testing, and production support.
• Investigate and resolve pricing, reimbursement, and claims adjudication issues.
• Collaborate with Provider Contracting, Claims, Business, and IT teams to implement configuration changes.
• Support UAT, production releases, and post-implementation validation activities.
• Create and maintain configuration documentation and testing evidence.

Work Authorization

Applicants must be legally authorized to work in the United States.

Themesoft Inc is an Equal Employment Opportunity employer. We consider qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, veteran status, or any other status protected by applicable federal, state, or local law.