NetworX Pricing & Reimbursement Specialist

Connect Tech+Talent; Austin (TX); On-site; USD 100,000 - 130,000; Full time

Job summary

Connect Tech+Talent is seeking a NetworX Configuration Analyst to support provider contract pricing, reimbursement configuration, and claims adjudication within the NetworX Pricing platform.

Ideal candidates will have strong healthcare payer experience and the ability to translate provider contract requirements into accurate pricing configurations, collaborating with cross-functional teams to implement changes and provide testing and validation support.

Qualifications

• Experience with NetworX Pricer and NetworX Modeler.
• Knowledge of FACETS configuration and claims adjudication.
• Provider contract and reimbursement configuration experience.
• Strong SQL skills for analysis and validation.
• Excellent analytical, troubleshooting, and communication skills.

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.

Skills

NetworX Pricer/Modeler

FACETS configuration

Provider contract configuration

SQL

Analytical communication skills

Job description

Connect Tech+Talent is seeking a NetworX Configuration Analyst to support provider contract pricing, reimbursement configuration, and claims adjudication within the NetworX Pricing platform.

Ideal candidates will have strong healthcare payer experience and the ability to translate provider contract requirements into accurate pricing configurations, collaborating with cross-functional teams to implement changes and provide testing and validation support.