Remote Medicare Pricing Analyst

WPS Health Solutions; Charlotte (NC); Hybrid; USD 45,000 - 56,000; Full time

Benefits offered by this job

Remote option

Hybrid work

401(k) match

Health insurance

Dental insurance

PTO

Professional development

Job summary

WPS Health Solutions is seeking a Medicare Pricing Analyst to research complex Medicare pricing issues and ensure accurate claims processing and coding guidelines. You will implement CMS pricing updates, maintain pricing data, and collaborate with CMS and MACs to ensure timely payments.

Qualifications include a health information-related degree and 1+ year of Medicare Part A/B claims processing experience, with strong analytical and documentation skills.

Qualifications

• Bachelor's degree in Health System Information or related field.
• 1+ year of experience in Medicare Part A/B claims processing.
• Knowledge of Medicare program and operations, including claims processing and billing procedures.
• Proficient in navigating systems to download and install CMS pricing files (FISS/MCS).
• Strong analytical and problem-solving skills.
• Excellent organizational skills with documentation for pricing changes.

Responsibilities

• Implement CMS system changes, validate updates, and test pricing data.
• Review Part A/B claims for proper application of guidelines and pricing rules.
• Respond to requests via OnBase with CMS and Shared System Maintainers resources.
• Review Fee Schedule Disclosures and pricing articles for CMS compliance.
• Maintain up-to-date records of CMS changes and validate pricing systems.

Skills

Medicare pricing knowledge

Analytical skills

Documentation skills

Collaboration

System navigation

Education

Bachelor's degree in Health System Information

Tools

FISS/MCS pricing files

Job description

WPS Health Solutions is seeking a Medicare Pricing Analyst to research complex Medicare pricing issues and ensure accurate claims processing and coding guidelines. You will implement CMS pricing updates, maintain pricing data, and collaborate with CMS and MACs to ensure timely payments.

Qualifications include a health information-related degree and 1+ year of Medicare Part A/B claims processing experience, with strong analytical and documentation skills.