Rates Configuration Specialist

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🔥 12 hours ago

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MedPOINT Management

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 1988

🏥 Healthcare

⚕️ Healthcare Insurance

Healthcare • Healthcare Insurance

MedPOINT Management is a California-based healthcare management services organization that supports independent practice associations (IPAs), provider networks, hospitals and contracted health plans with clinical quality, care management, administrative operations and technology solutions. For more than 32 years MPM has provided services including provider network operations, case management, utilization management, claims operations, credentialing, HEDIS/STARs quality measurement and analytics (via Cozeva), call center and financial management, and digital provider portals and resource libraries. The company emphasizes data security and compliance (SOC 2 and HITRUST e1 certifications for its EZ-CAP and Provider Web Portals) and focuses on enabling value-based care, quality improvement, and operational support for providers and payers.

📋 Description

• Configure, maintain, and update rate tables and fee schedules within healthcare management systems • Audit and validate rate configurations to ensure accuracy and compliance with contractual agreements • Collaborate with contracting, claims, and provider relations teams to implement rate changes • Identify and resolve discrepancies in rate data, escalating issues as needed • Document configuration processes, updates, and changes for internal records and compliance purposes • Support system testing and quality assurance for rate-related updates and implementations • Generate reports and analysis related to rate performance and configuration accuracy

🎯 Requirements

• Experience in healthcare administration, managed care, or a related field • Familiarity with fee schedules, CPT codes, and healthcare reimbursement methodologies • Strong analytical and data entry skills with a high level of attention to detail • Proficiency in Microsoft Excel and healthcare management or claims processing systems • Ability to manage multiple priorities and meet deadlines in a fast-paced environment • Strong communication skills for cross-departmental collaboration • Associate's or Bachelor's degree in Healthcare Administration, Business, or a related field preferred

🏖️ Benefits

• 401(k) • 401(k) matching • Bonus based on performance • Company parties • Dental insurance • Employee discounts • Free food & snacks • Health insurance • Opportunity for advancement • Paid time off • Parental leave • Savings bank • Training & development • Vision insurance • Wellness resources