Remote Healthcare Pricing Config Specialist

Cognizant; Rancho Cordova (CA); À distance; USD 113 000 - 130 000; Plein temps

Avantages offerts par ce poste

Medical/Dental/Vision/Life Insurance

401(k) plan and contributions

Paid holidays + PTO

Long-term/Short-term Disability

Paid Parental Leave

Employee Stock Purchase Plan

Résumé du poste

Cognizant is seeking a NetworX Pricing Configuration Consultant for a remote role in the United States. You will support provider contract pricing, reimbursement configuration, and claims adjudication for healthcare payer organizations.

Collaborate with Contracting, Claims, Business, and IT to implement configuration enhancements and ensure accurate pricing outcomes. Strong SQL and communication skills are essential to succeed in a fast-paced environment.

Qualifications

• Experience supporting healthcare payer organizations with provider contract pricing and reimbursement configuration.
• Hands-on experience with NetworX Pricer and NetworX Modeler.
• Experience with FACETS configuration and claims adjudication processes.
• Knowledge of provider contract configuration, fee schedules, reimbursement methodologies, and pricing validation.
• Strong SQL skills for data analysis, validation, and troubleshooting.

Responsabilités

• Configure and maintain provider contracts, fee schedules, qualifier groups, and reimbursement methodologies within the NetworX Pricing platform.
• Analyze business and contractual requirements and translate them into effective pricing and reimbursement configurations.
• Perform pricing validation, claims analysis, testing, and production support to ensure accurate claims adjudication and reimbursement outcomes.
• Partner with Provider Contracting, Claims Operations, Business, and IT teams to implement and support configuration enhancements.
• Investigate and resolve pricing, reimbursement, and claims adjudication issues while maintaining configuration documentation and testing evidence.

Connaissances

SQL

Communication skills

Analytical thinking

Pricing configuration

Outils

NetworX Pricer

NetworX Modeler

FACETS

SQL

Description du poste

Cognizant is seeking a NetworX Pricing Configuration Consultant for a remote role in the United States. You will support provider contract pricing, reimbursement configuration, and claims adjudication for healthcare payer organizations.

Collaborate with Contracting, Claims, Business, and IT to implement configuration enhancements and ensure accurate pricing outcomes. Strong SQL and communication skills are essential to succeed in a fast-paced environment.