Pricing Coordinator

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

Job summary

Health Care Service Corporation (HCSC) seeks a professional to provide technical direction in defining and implementing CMS Medicare Part B reimbursement rates. The role focuses on CMS methodologies, monitoring changes, and informing management of implications for Indian Health Service fiscal intermediary processes.

You will obtain current Medicare rates, work with systems to load them, and distribute pricing information to staff.

Qualifications

• Bachelor degree in Math, Statistics, or Computer Science or 4 years healthcare industry experience.
• 1 year experience with Access and 1 year experience with Excel.

Responsibilities

• Provide technical direction on defining and implementing CMS Part B reimbursement methodologies.
• Monitor CMS Part B pricing procedures and assess impact on Indian Health Service FI processes; inform management of implications.
• Obtain current Medicare rates and coordinate loading into systems.
• Distribute pricing information to staff for use in pricing.

Skills

Verbal and written communication

Math skills

Self-starter

Data analysis

Education

Bachelor degree in Math, Statistics or Computer Science

4 years experience in the health care industry

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.

Job Summary

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)

Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!

Pay Transparency Statement:

At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees. Learn more about our benefit offerings by visiting https://careers.hcsc.com/totalrewards.

The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan.

Flex employees are expected to be in the office a minimum of three days a week. Management will have discretion to modify an employee’s weekly schedule for exigent circumstances.

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.

Base Pay Range

$47,500.00 - $86,000.00

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