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Facets NetworX Pricing Analyst

Remote • Posted 12 hours ago • Updated 12 hours ago

Contract Corp To Corp

Contract Independent

Contract W2

12 Months

No Travel Required

Remote

Depends on Experience

Fitment

Dice Job Match Score™

⭐ Evaluating experience...

Job Details

Skills

Facets
NetworX
Pricer
configuration
claims
SQL
Healthcare Payer

Summary

10+ years of experience in Healthcare Payer Operations and Facets Configuration.
Strong hands-on experience with Facets NetworX Pricer.
Proven experience in Provider Pricing and Reimbursement Methodologies.
Strong experience with claims analysis and pricing validation.
Proficiency in SQL, Excel, and MS Access.
Strong requirements analysis, documentation, problem-solving, and communication skills.
Experience supporting production incidents, defects, and issue resolution within a healthcare payer environment.
Perform Facets NetworX Pricer configuration and maintenance for provider pricing, reimbursement, and contract-related requirements.
Configure and validate provider pricing and reimbursement methodologies to ensure accurate claims adjudication.
Analyze claims and perform claims pricing validation to identify pricing discrepancies, defects, overpayments, and underpayments.
Review provider contracts and translate pricing requirements into appropriate Facets/NetworX configuration.
Conduct data analysis and validation using SQL, Microsoft Access, and advanced Microsoft Excel.
Work closely with business, claims, provider, configuration, and technology teams to ensure accurate implementation of pricing requirements.

Employers have access to artificial intelligence language tools (“AI”) that help generate and enhance job descriptions and AI may have been used to create this description. The position description has been reviewed for accuracy and Dice believes it to correctly reflect the job opportunity.

Dice Id: 90962207
Position Id: 9051382
Posted 12 hours ago

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