Pricing Coordinator

Customer Service; Albuquerque (NM); On-site; USD 48,000 - 86,000; Full time

Job summary

HCSC is seeking a senior technical lead to define and implement provider reimbursement rates using CMS Medicare methodologies, with a focus on Part B programs. You will monitor pricing procedures, assess effects on Indian Health Service FI processes, and share insights with management to guide pricing decisions.

Requirements include a bachelor degree in Math/Statistics/CS or 4 years in healthcare, plus data analysis experience and proficiency with Access and Excel; familiarity with healthcare

Qualifications

• 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.

Responsibilities

• Provide technical direction on defining and implementing provider reimbursement rates based on CMS Medicare methodologies.
• Monitor structure and changes to Medicare Part B pricing procedures and evaluate impact on IHS FI processes.
• Inform management of implications and make recommendations as appropriate.

Skills

Data analysis

Healthcare finance

Excel

Access

Communication

Education

Bachelor's degree in Math/Statistics/CS

Tools

Access

Excel

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: $47,500.00 - $86,000.00

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. We are a drug-free and smoke-free workplace. Employment may be contingent upon successful completion of drug screening in accordance with applicable law.