Remote Medicare Pricing Analyst: CMS & Claims

WPS—A health solutions company; Missouri; On-site; USD 45,000 - 56,000; Full time

Benefits offered by this job

Remote work options available

Performance bonus

401(k) with match

Competitive PTO

Health insurance and telehealth

Professional development

Job summary

WPS, a health solutions company, seeks a Medicare Pricing Analyst to research complex pricing and reimbursement issues, validate CMS pricing updates, and maintain accurate pricing information across Medicare systems.

Role involves collaborating with CMS, Shared System Maintainers, and MACs to ensure timely claims payment and system accuracy. Remote-friendly with potential hybrid scheduling.

Qualifications

• Bachelor’s degree in Health System Information or related discipline.
• 1 or more years of experience in Medicare Part A and Part B claims processing.
• Knowledge of Medicare program and operations and billing procedures.
• Proficient in downloading/installing files (FISS/MCS pricing files).
• Strong analytical and problem-solving skills.
• Ability to coordinate and maintain detailed documentation for Change Requests/TDLs.

Responsibilities

• Research CMS pricing updates and validate system changes.
• Review Part A and Part B claims and pricing using CMS resources.
• Address Requests for Assistance via OnBase and provide CMS/pricing guidance.
• Review Fee Schedule Disclosures and pricing articles for CMS compliance.
• Maintain records of CMS changes and validate pricing systems.

Skills

Analytical skills

Problem-solving

Documentation

Collaboration

Education

Bachelor’s degree in Health System Information

Tools

FISS

MCS pricing files

Job description

WPS, a health solutions company, seeks a Medicare Pricing Analyst to research complex pricing and reimbursement issues, validate CMS pricing updates, and maintain accurate pricing information across Medicare systems.

Role involves collaborating with CMS, Shared System Maintainers, and MACs to ensure timely claims payment and system accuracy. Remote-friendly with potential hybrid scheduling.