Healthcare Provider Pricing Specialist
2 weeks ago
POSITION SUMMARY/RESPONSIBILITIES
The Healthcare Provider Pricing Specialist is responsible for managing and supervising the integration of provider agreements and compensation schedules into claims processing systems, ensuring the accuracy and consistency of claims payments.
This role involves analyzing intricate issues related to claim disbursements. The Specialist will serve as a key intermediary among the Auditing, Benefits Configuration, and Provider Data Departments. Additionally, this position provides essential support to cross-functional teams concerning provider pricing.
Key Responsibilities:
1. Maintain and oversee the loading of provider contracts into systems.
2. Analyze complex problems associated with claim payments.
3. Foster positive relationships within the department and with other departments.
4. Operate with a degree of autonomy.
EDUCATION/EXPERIENCE
A Bachelor’s degree in computer science, healthcare, or a related discipline is preferred. A minimum of one year of experience in the healthcare sector may be considered in lieu of formal education. Experience in System Configuration or SQL is advantageous.
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