NetworX Configuration Analyst

Smart IT Frame LLC; United States; Vor Ort; USD 75.000 - 110.000; Vollzeit

Zusammenfassung

Smart IT Frame LLC 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, expertise in NetworX and FACETS, and the ability to translate provider contract requirements into accurate pricing configurations.

The role focuses on configuring contracts, fee schedules, reimbursement methodologies, and validating pricing and

Qualifikationen

• NetworX Pricer experience
• NetworX Modeler experience
• FACETS configuration and claims adjudication knowledge
• Experience with provider contracts and reimbursement configuration

Aufgaben

• 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.

Jobbeschreibung

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.