Hospital Price Transparency Analyst

Title: Hospital Price Transparency Analyst

Location: Parsippany-Troy Hills, NJ, USA

Job Purpose

The Hospital Price Transparency Analyst will work to maintain and optimize automated processes related to the pricing transparency tool, including but not limited to, analyzing hospital claims data, auditing the results for data integrity, and resolving identified data issues. The Hospital Price Transparency Analyst will also be responsible for maintaining and optimizing the proprietary rule engine to ensure optimal client experience and compliance with current industry regulations. 

 

Duties & Responsibilities

 

Maintain established proprietary pricing transparency tool to ensure that product is compliant with current regulations and code sets

Audit price index results after data parsing and work with the development team to resolve any identified data issues

Create price index reports in a client-friendly format following confirmation of data integrity

Evaluates the need for and participates in the development of future product enhancements, including defining acceptance criteria and translating user-level requirements into a logical design that meets compliance requirements.

Tests development work to assure accuracy and consistency with product specifications

Answer product questions from project management, product implementation consultants, marketing, and sales teams in addition to client questions

Attend virtual meetings with clients to review files and ask/address questions relating to the client's specific dataset

Stay abreast of evolving regulatory requirements and code changes; apply this information appropriately to ensure integrity of the pricing transparency product

Support other departments by providing relevant input and industry expertise to optimize the client experience

Other duties as assigned

Use, protect and disclose patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards

Understand and comply with Information Security and HIPAA policies and procedures at all times

Limit viewing of PHI to the absolute minimum as necessary to perform assigned duties

 

Qualifications

 

High-school diploma or equivalent required

Minimum of 5 years inpatient/outpatient combined coding and/or billing experience in a healthcare environment

Active coding certification from the American Health Information Management Association (AHIMA) or the American Academy of Professional Coders (AAPC) is preferred

Advanced awareness and understanding of government regulations and resources impacting hospital price transparency rules

Practical knowledge of healthcare provider business processes including clinical coding, chargemaster management, charge capture, billing and/or charge reconciliation

Able to consistently interpret and apply official regulatory guidelines to real-world scenarios

Proficiency in Microsoft Office Suite, with strong Excel skills

Strong interpersonal skills, ability to communicate well at all levels of the organization

Strong problem solving and creative skills and the ability to exercise sound judgment and make decisions based on accurate and timely analyses

High level of integrity and dependability with a strong sense of urgency and results oriented 

Excellent written and verbal communication skills required

 

Working Conditions

 

Must possess a smart-phone or electronic device capable of downloading applications, for multifactor authentication and security purposes

Physical Demands: While performing the duties of this job, the employee is occasionally required to move around the work area; Sit; perform manual tasks; operate tools and other office equipment such as computer, computer peripherals and telephones; extend arms; kneel; talk and hear

Mental Demands: The employee must be able to follow directions, collaborate with others, and handle stress

Work Environment: The noise level in the work environment is usually minimal

 

 

Med-Metrix will not discriminate against any employee or applicant for employment because of race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, genetic information (including family medical history), political affiliation, military service, veteran status, other non-merit based factors, or any other characteristic protected by federal, state or local law.