Medicaid Configuration Analyst

Job Summary

A company is looking for a Pricing and Reimbursement Analyst.

Key Responsibilities:

• Conduct in-depth research and analysis of State Medicaid fee-for-service provider contracts and related documentation
• Translate Medicaid reimbursement methodologies into actionable configuration requirements for Facets and NetworXPricer systems
• Collaborate with technical teams to ensure accurate implementation and testing of configuration changes

Required Qualifications:

• Bachelor's degree in Healthcare Administration, Information Systems, Business, or a related field, or equivalent work experience
• Proven experience (typically 3+ years) in researching State Medicaid reimbursement methodologies
• Experience in defining configuration requirements for healthcare payer systems, specifically with Facets and/or NetworXPricer
• Strong understanding of healthcare coding systems (CPT, HCPCS, ICD-10, DRG, Revenue Codes, POS codes)
• Familiarity with State Medicaid Administrative Code and related documentation