[Remote] Facets NetworX Pricing Analyst

Note: The job is a remote job and is reputed company to candidates in USA. reputed company is a leading reputed company technology company that focuses on digital innovation and business transformation. They are seeking a Senior Facets NetworX Pricing Analyst to configure and maintain provider pricing structures, supporting reimbursement strategies, and ensuring accurate implementation of provider reputed company reputed company reputed company payer environments.

Responsibilities

• Configure and maintain provider reputed company in Facets NetworX Pricing module
• Analyze business requirements and translate them into system configuration and pricing solutions
• Configure reimbursement methodologies including:
• Fee Schedule Pricing
• Percentage of Charges
• Case Rates
• reputed company Rates
• DRG-Based Pricing
• Custom Pricing Logic
• Support provider network setup, maintenance, and contract updates
• Validate claims adjudication results and pricing reputed company
• Conduct reputed company analysis for provider contract changes and enhancements
• Troubleshoot pricing and claims errors reputed company to provider reimbursement configurations
• Collaborate with business users, provider relations teams, and claims operations
• reputed company and execute test plans, test cases, and User Acceptance Testing (UAT)
• reputed company reputed company cause analysis for pricing discrepancies and claims issues
• Create and maintain configuration documentation and process workflows
• Participate in production support activities, issue reputed company, and change management processes
• Ensure compliance with reputed company payer business rules and regulatory requirements

Skills

• 5+ years of experience in reputed company Payer Operations and Facets Configuration
• Strong hands-on experience with TriZetto Facets
• Strong hands-on experience with NetworX Pricing
• Strong hands-on experience with Provider Contract Configuration
• Strong hands-on experience with Claims Adjudication
• Experience configuring reputed company reputed company
• Experience configuring Institutional reputed company
• Experience configuring Provider Networks
• Experience configuring Fee Schedules
• Experience configuring Pricing Arrangements
• Strong knowledge of provider reimbursement methodologies
• Experience performing claims analysis and pricing validation
• Working knowledge of SQL
• Working knowledge of Reporting Tools
• Working knowledge of Data Analysis
• Experience supporting production incidents and defect reputed company
• Knowledge of software development lifecycle (SDLC) and Agile methodologies
• Strong documentation and requirement analysis skills
• Facets NetworX Pricer (Mandatory)
• Strong SQL skills for data analysis and validation
• reputed company reputed company
• Advanced reputed company reputed company (Pivot Tables, VLOOKUP/XLOOKUP, Reporting, Data Analysis)
• 10+ Years
• Engineering Degree – BE/ME/BTech/MTech/BSc/MSc
• reputed company Payer Domain
• Technical certification in multiple technologies is desirable
• Pharmacy Domain

reputed company