Remote Medicare Pricing Analyst

WPS—A health solutions company; Iowa (LA); Hybrid; USD 45,000 - 56,000; Full time

Benefits offered by this job

Remote work options

Health insurance

401(k) with company match

Paid time off

Professional development

Job summary

WPS, a health solutions company, is seeking a Medicare Pricing Analyst to research complex pricing and reimbursement issues, ensuring accurate claims processing and coding guidelines. The role supports CMS pricing updates, maintains pricing data, and collaborates with CMS, Shared System Maintainers, and MACs for timely payments.

The position also involves responding to interdepartmental requests, testing and validating pricing systems, and assisting the Technical Claims team on pricing projects

Qualifications

• Bachelor’s degree in Health System Information or related discipline.
• 1+ years of experience in Medicare Part A and Part B claims processing.
• Knowledge of Medicare program operations and claims processing/billing.
• Proficient in downloading/installing CMS pricing files (FISS/MCS).
• Strong analytical and problem-solving skills.
• Organizational skills and ability to document Change Requests and TDLs.
• Ability to collaborate with the Technical Claims team.

Responsibilities

• Research and resolve complex Medicare pricing and reimbursement issues.
• Support CMS pricing updates and validation; maintain pricing data in Medicare systems.
• Collaborate with CMS, Shared System Maintainers, and MACs to ensure accurate claims payment.
• Assist with reviews of pricing guidance and Fee Schedule disclosures.
• Maintain detailed records of CMS-related changes and validate pricing systems.
• Work with CMS and Shared System Maintainers to implement system changes and troubleshoot.

Skills

Analytical skills

Problem-solving

Organizational skills

Collaboration

Documentation

Education

Bachelor’s degree in Health System Information or related discipline

Job description

WPS, a health solutions company, is seeking a Medicare Pricing Analyst to research complex pricing and reimbursement issues, ensuring accurate claims processing and coding guidelines. The role supports CMS pricing updates, maintains pricing data, and collaborates with CMS, Shared System Maintainers, and MACs for timely payments.

The position also involves responding to interdepartmental requests, testing and validating pricing systems, and assisting the Technical Claims team on pricing projects