Pricing Coordinator

Health Care Service Corporation; Albuquerque (NM); On-site; USD 42,000 - 93,000; Full time

Job summary

Health Care Service Corporation (HCSC) is seeking a technical lead responsible for defining and implementing provider reimbursement rates, aligning with CMS Medicare methodologies, primarily for Part B. This role includes monitoring pricing procedures and evaluating impacts on Indian Health Service fiscal intermediary processes.

Responsibilities include obtaining current Medicare rates, coordinating with systems to load rates, and distributing information to staff for pricing.

Qualifications

• Data analysis experience required
• Verbal and written communication skills
• Math skills

Responsibilities

• Provide technical direction on defining and implementing provider reimbursement rates based on CMS Medicare methodologies, primarily Part B.
• Monitor Part B pricing procedures and evaluate impact on IHS FI processes.
• Obtain current Medicare rates and coordinate with systems to load and distribute to staff.

Job description

At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers.

Join HCSC and be part of a purpose-driven company that will invest in your professional development.

This Position Is Responsible For Providing Technical Direction On Defining And Implementing Provider Reimbursement Rates Based On Center For Medicare And Medicaid Services (Cms) Medicare Methodologies, Primarily In The Part B Programs. Monitoring The Structure Of And Changes To The Medicare Part B Pricing Procedures And Evaluating The Impact On Indian Health Service (Ihs) Fiscal Intermediary (Fi) Processes; Informing Management Of The Implications And Making Recommendations As Appropriate. Obtaining Current Medicare Rates, Working With Systems To Have Them Loaded, And/Or Distributing The Information To Staff To Use In Pricing.

JOB REQUIREMENTS:

• 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.

PREFERRED JOB REQUIREMENTS:

• Familiarity with research techniques.
• Knowledge of Medicare and Medicaid reimbursement methodologies and private insurance reimbursement, claims processing concepts, and medical classification coding systems.
• Experience developing and evaluating reimbursement methodologies.
• Experience with PC, mainframe applications and encoding systems.

Claims processing experience.

Preference in filling vacancies is given to qualified Indian candidates in accordance with the Indian Preference Act of 1934 (title 25, USC Section 472)

Native American Indian Preference shall apply to this position pursuant to the Indian Self-Determination and Education Assistance Act (24 U.S.C. 450, et seq.), 25 CFR 271.44 and other relevant laws (title 25, U.S. code, Section 472 & 473)

Compensation: $41,700.00 - $92,800.00

Exact compensation may vary based on skills, experience, and location

HCSC Employment Statement:

We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.