Contract Pricing Configuration Analyst

Job not on LinkedIn

🔥 8 minutes ago

🦌 Connecticut, New Jersey, +2 more states – Remote

🦌 Connecticut – Remote 🏖️ New Jersey – Remote 🗽 New York – Remote 🔔 Pennsylvania – Remote

💵 $70.5k - $94.4k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🧐 Analyst

👻 Ghost score 14%

What it means: the chance that no one is really hiring for this job.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.Why this score:

• Just posted.
• Jobs at this company usually fill in 21 days.

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Horizon Connect @ Wall BCBSNJ

WebsiteLinkedInAll Job Openings

2 - 10 employees

⚕️ Healthcare Insurance

🏥 Healthcare

Healthcare Insurance • Healthcare

Horizon Connect @ Wall BCBSNJ is a LinkedIn presence or local program/office associated with Horizon Blue Cross Blue Shield of New Jersey (BCBSNJ). Based on the name and context, it appears to be connected to Horizon BCBSNJ’s health insurance operations and local outreach or member/provider engagement in the Wall, NJ area. Publicly available information provided is limited and mostly LinkedIn site chrome rather than a company profile, so this description is conservative and based on the affiliation indicated by the name.

📋 Description

• Configure and maintain provider reimbursement arrangements for healthcare professionals, institutions, and ancillaries • Interpret company reimbursement arrangements • Consult with contract managers or reimbursement leads on contract-term interpretation and configuration • Unit test simple configuration changes to ensure rate-load accuracy • Respond to internal and external provider fee requests • Resolve configuration issues identified by Service or Provider Relations • Monitor and test price rules, fee schedules, and contract loads • Assist with internal and external audits, including SOX and SSAE16 • Assist Leads with enterprise initiatives impacting pricing

🎯 Requirements

• Strong analytical skills dealing with hospitals, ancillary and provider contracts • High School Diploma/GED required • 3-5 years of Health Care experience specifically in provider contract and pricing configuration • In lieu of degree, 5 years of Health Care experience, specifically in provider contract and pricing configuration • Prior experience in one or more claim systems • Experience with pricing and/or provider contract arrangements • Preferred experience with NetworX Pricer and NetworX PBA • Preferred knowledge of one or more claim systems, especially claims processing, pricing and contract setup • Preferred knowledge of business and technical requirements • Preferred claims processing systems knowledge • Preferred knowledge of testing life cycle • Working knowledge of MS tools, including MS Office products, MS Access, SQL Server • Excellent verbal and written communication and presentation skills • Client service focus and ability to empathize • Willingness to cross-train and be cross-trained • Detail-oriented with strong organizational and data processing skills • Ability to follow detailed instructions • Problem-solving, analytical, and research skills • Ability to learn quickly and apply learning to new situations • Flexibility to change as appropriate • Ability to maintain attendance to support required quality and quantity of work • Multi-tasking and workload prioritization skills • Must live in New Jersey, New York, Pennsylvania, Connecticut, or Delaware

🏖️ Benefits

• Comprehensive health benefits (Medical/Dental/Vision) • Retirement Plans • Generous PTO • Incentive Plans • Wellness Programs • Paid Volunteer Time Off • Tuition Reimbursement

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