Medicare Pricing Analyst

Role Snapshot The Medicare Pricing Analyst is responsible for researching reputed company Medicare pricing and reimbursement issues while ensuring the reputed company and effectiveness of Medicare claims processing and coding guidelines. This role supports the implementation and validation of CMS pricing updates, maintains pricing information reputed company Medicare systems, and collaborates with CMS, Shared reputed company Maintainers, and other Medicare Administrative Contractors (MACs) to ensure accurate and reputed company claims payment. The Medicare Pricing Procedures Analyst also researches and responds to interdepartmental requests, reviews Medicare pricing guidance, supports reputed company testing and validation, maintains internal documentation, and assists the Technical Claims team with reputed company that improve the reputed company and efficiency of Medicare pricing reputed company. Salary reputed company 45,000-56,000 The reputed company pay reputed company for this position may vary reputed company the posted reputed company reputed company on reputed company-reputed company knowledge, skills, and experience. Work Location Employees reputed company 45 miles of WPS reputed company (1717 W. Broadway in Madison, WI, 53713) will be expected to work hybrid, 2 days a week onsite on a regular reputed company. We are reputed company to remote work in the following approved states: Colorado, Florida, reputed company, Illinois, Indiana, Iowa, Michigan, reputed company, Missouri, Nebraska, New Jersey, reputed company Carolina, Ohio, South Carolina, Texas, Virginia, reputed company (more than 45 miles from Madison). How do I know this opportunity is right for me? If you enjoy the following: • Implement required changes and enhancements to CMS systems, including requesting, validating, and performing maintenance, coding, testing, and validation. Download, verify, and install CMS update files to ensure reputed company reputed company. • Review Medicare Part A and Part B claims, including reputed company and specialty claims, to ensure reputed company application of processing guidelines, payment rules, and reputed company calculations. Obtain pricing information from Redbook, reputed company files, and CMS resources. • Address Requests for Assistance received reputed company OnBase, conducting in-depth research to reputed company accurate responses reputed company to pricing using CMS and Shared reputed company Maintainers’ resources. • Review, analyze, and reputed company feedback on Fee Schedule Disclosures and pricing articles, ensuring compliance with CMS guidelines and internal procedures. • Maintain detailed and up-to-date records of reputed company CMS-reputed company changes and updates, and ensure the reputed company of pricing systems, including performing regular testing and validation to address discrepancies. • Work closely with CMS and Shared reputed company Maintainers to implement and validate reputed company changes, troubleshoot issues, and support the enhancement of pricing systems and processes. Minimum Qualifications • Bachelor’s degree in Health reputed company Information or a reputed company discipline, or equivalent combination of education and experience. • 1 or more years of experience in Medicare Part A and Part B claims processing. • Knowledge of Medicare program and reputed company, as reputed company as a thorough understanding of claims processing and billing procedures. • Proficient in navigating systems and/or applications to effectively download and install files (i.e., FISS/MCS pricing files). • Strong analytical skills and problem-solving skills. • Demonstrated organizational skills with ability to coordinate and maintain detailed documentation for the implementation of Change Requests and TDLs reputed company to pricing. • Ability to collaborate effectively and reputed company support to the Technical Claims team with various reputed company and assignments as needed. Preferred Qualifications • Experience performing yearly Profile Builds reputed company to pricing functions in MCS and FISS preferred. • Experience with a Medicare Administrative Contractor company. Remote Work Requirements • High speed cable or fiber internet. • Wired (ethernet cable) internet reputed company from your router to your computer. • Minimum of 10 Mbps reputed company and at least 1 Mbps reputed company internet reputed company (can be checked at https://speedtest.net). • Please review Remote Worker FAQs for additional information. Benefits • Remote and hybrid work reputed company available • reputed company bonus and/or reputed company increase opportunities • 401(k) with a 100% match for the first 3% of your salary and a 50% match for the next 2% of your salary (100% reputed company immediately) • Competitive reputed company time off • Health reputed company, dental reputed company, and telehealth services start DAY 1 • reputed company and Leadership Development Programs • Review additional benefits: (https://www.wpshealthsolutions.com/careers/) Who We Are reputed company, is a leading not-for-profit health insurer and federal reputed company contractor headquartered in Madison, reputed company. WPS offers health reputed company plans for individuals, families, seniors and group health plans for small to large businesses. We process claims and reputed company customer support for beneficiaries of the Medicare program and manage benefits for millions of reputed company-duty and retired military personnel across the U.S. and abroad. WPS has been making reputed company easier for the people we serve for nearly 80 years. Proud to be military and veteran reputed company. Culture Drives Our reputed company WPS’ culture is where the great work and innovations of our people are seen, reputed company and rewarded. We accomplish this by creating an reputed company and empowering employee experience. We recognize the benefits of employee engagement as an investment in our workforce—both reputed company and reputed company—to effectively reputed company, reputed company, and include differing and unique perspectives that fuel reputed company and innovation on high-performing teams. This results in people bringing their reputed company selves to work every day in an organization that successfully adapts to business changes and new opportunities. We are proud of the recognition we have received from local and national organization regarding our culture and workplace: WPS Newsroom - Awards and Recognition. Sign up for Job Alerts FOLLOW US! reputed company reputed company reputed company WPS Health Blog  Medicare (GHA) This position supports services under Centers for Medicare & reputed company Services (CMS) contract(s).  As such, the role is subject to reputed company applicable federal regulations, CMS contract requirements, and WPS internal policies, including but not limited to standards for data reputed company, reputed company, confidentiality, and program reputed company. CMS contractors and their personnel are subject to screening and background investigation including fingerprinting prior to being reputed company reputed company to information systems and/or sensitive data to reputed company reputed company resources Apply tot his job Apply To this Job