- We offer excellent medical, dental, and vision plan options that provide coverage to employees and dependents.
- Join the team and we will invest in your future
- Accrued PTO starting day one, plus additional days off when you're not feeling well, to observe holidays.
- We care about your wellbeing. From Commuter Benefits to FSAs we've got you covered.
- Through continued education/mentorship on the job and our investment in LinkedIn Learning, we're focused on your growth as a working professional.
-
Area Air Logistics Pricing Specialist
5 days ago
Kuehne+Nagel Jersey City, United StatesAre you thinking about improving your career development and your professional growth? We invite you to join one of the most successful international logistics organizations here at Kuehne+Nagel. Our Jersey City branch is looking for a new Area Air Logistics Pricing Specialist to ...
-
Pricing Specialist
1 week ago
Eastridge Workforce Solutions New York, United StatesEastridge Workforce Solutions has partnered with a prestigious national law firm to find a highly qualified Pricing Specialist. Based in various locations, the Pricing Specialist will play a crucial role in billing rates and special fee arrangement administration, as well as prov ...
-
Pricing Specialist
5 days ago
FIS - Fidelity Information Services New York, United StatesAre you curious, motivated, and forward-thinking? At FIS youll have the opportunity to work on some of the most challenging and relevant issues in financial services and technology. Our talented people empower us, and we believe in being part of a t Pricing, Specialist, Financial ...
-
Pricing Specialist
1 week ago
Consultative Search Group New York, United StatesNew Pricing Analyst Role Available · NYC, Wash DC, Houston, Dallas, Denver, LA, SF and Silicon Valley, Orange County · Remote with Flexibility(must be flexible to come to office every now and then & must live in a commutable range to one of the following cities) · If you are look ...
-
Pricing Specialist
1 week ago
Eastridge New York, United StatesJob Description · Job DescriptionEastridge Workforce Solutions has partnered with a prestigious national law firm to find a highly qualified Pricing Specialist. Based in various locations, the Pricing Specialist will play a crucial role in billing rates and special fee arrangemen ...
-
Pricing Specialist
2 days ago
Consultative Search Group New York, United StatesJob Description · Job DescriptionNew Pricing Analyst Role Available · NYC, Wash DC, Houston, Dallas, Denver, LA, SF and Silicon Valley, Orange County · Remote with Flexibility(must be flexible to come to office every now and then & must live in a commutable range to one of the fo ...
-
Pricing Specialist
1 week ago
Jobs for Humanity New York, United StatesCompany Description · Jobs for Humanity is collaborating with FIS Global to build an inclusive and just employment ecosystem. We support individuals coming from all walks of life. · Company Name: FIS Global · Job Description · Position Type : · Full time · Type Of Hire : ...
-
Pricing Specialist
4 days ago
Jobs for Humanity New York, United StatesCompany Description · Jobs for Humanity is collaborating with FIS Global to build an inclusive and just employment ecosystem. We support individuals coming from all walks of life. · Company Name: FIS Global · Job Description · Position Type : · Full time · Type Of Hire : ...
-
Pricing Specialist
3 weeks ago
FIS Global New York, United States OTHERPosition Type : · Full time Type Of Hire : · Experienced (relevant combo of work and education) Education Desired : · Bachelor of Accounting Travel Percentage : · 1 - 5%Job Description · Are you curious, motivated, and forward-thinking? At FIS you'll have the opportunity to w ...
-
Pricing Specialist
5 days ago
FIS Global New York, United States OTHERPosition Type : · Full time Type Of Hire : · Experienced (relevant combo of work and education) Education Desired : · Bachelor of Accounting Travel Percentage : · 1 - 5%Job Description · Are you curious, motivated, and forward-thinking? At FIS you'll have the opportunity to w ...
-
Pricing Analyst Specialist
5 days ago
FIS - Fidelity Information Services New York, United StatesAre you curious, motivated, and forward-thinking? At FIS youll have the opportunity to work on some of the most challenging and relevant issues in financial services and technology. Our talented people empower us, and we believe in being part of a t Pricing Analyst, Pricing, Spec ...
-
Rates & Pricing Specialist
1 hour ago
Taylor Root New York, United StatesWork for a top law firm on a small team and work hands on with clients and Senior Leaders at the firm. · Responsibilities · Ensure Alternative Fee Arrangements (AFAs) are set up · Handle rate reviews and audits · Create and maintain rate cards · Update annual renewal rates wit ...
-
Director, Pricing Specialist
1 week ago
Fitch Group New York, United StatesCommercial Pricing Strategist · Fitch Solutions is a leading provider of insights, data and analytics. It informs investment strategies, strengthens risk management capabilities and helps identify strategic opportunities through its companies and business units including BMI, Cr ...
-
Rates and Pricing Specialist
2 weeks ago
Noor Associates New York, United StatesJob Description · Job DescriptionESSENTIAL DUTIES AND RESPONSIBILITIES: · Liaise with Billing Partners and Revenue Team/Pricing Team including Revenue Manager and CFO to obtain information regarding client negotiated billing arrangements. · Respond to client inquiries/questions ...
-
Pricing Analyst Specialist
6 days ago
FIS Global New York, United States OTHERPosition Type : · Full time Type Of Hire : · Experienced (relevant combo of work and education) Education Desired : · Bachelor of Business Administration Travel Percentage : · 5 - 10%Job Description · Are you curious, motivated, and forward-thinking? At FIS you'll have the op ...
-
Real-time Pricing Specialist
1 week ago
Bloomberg New York, United StatesReal-time Pricing Specialist · **New York, NY** · Posted Mar 1, Requisition No · We are Bloomberg Enterprise Data - fast paced, innovative and expanding We partner closely with our clients, taking time to understand their unique businesses and individual data and financial tec ...
-
Real-time Pricing Specialist
6 days ago
Bloomberg New York, United States Full timeWe are Bloomberg Enterprise Data - fast paced, innovative and expanding We partner closely with our clients, taking time to understand their unique businesses and individual data and financial technology (FinTech) needs. Our endless selection of datasets, covering all asset types ...
-
ETF Pricing Engineering Specialist
1 week ago
Hudson River Trading New York, United StatesHudson River Trading (HRT) is seeking an ETF Pricing Engineering Specialist to join our high-impact team working on the firm's growing ETF efforts. In this role, you'll collaborate with global trading teams, interface with automated trading systems across asset classes and region ...
-
Pricing Specialist
3 weeks ago
Sobel Network Shipping Co. Inc Rockville Centre, United StatesSobel Network Shipping Co., Inc. is a worldwide freight forwarder that has been providing turnkey logistics solutions for customers since 1949. We enable companies to respond to global opportunities, connect with new suppliers and customers, and leverage shipping solutions that t ...
-
Med Review Inc New York, United StatesPosition Summary · At MedReview, our mission is to bring accuracy, accountability and clinical excellence to healthcare. As such, we are a leading authority in payment integrity solutions including DRG Validation, Cost Outlier and Readmission reviews. · Pricing and analysis of in ...
Team Lead, Inpatient Claims Pricing Specialist - New York, United States - Med Review Inc
Description
Position SummaryAt MedReview, our mission is to bring accuracy, accountability and clinical excellence to healthcare. As such, we are a leading authority in payment integrity solutions including DRG Validation, Cost Outlier and Readmission reviews.
Pricing and analysis of inpatient medical claims utilizing NYCHSRO/MedReview and payer specific systems, adjudication platforms, policies, and procedures.
Provide support to various departments related to claim status, claim adjudication questions, and any basic questions related to the adjudication of an inpatient medical claim.
Candidate should be highly motivated, with strong pricing background including experience in platforms such as Facets, Webstrat, and Encoder.This individual must have excellent communication skills, must be analytical, have strong problem solving skills, and have the ability to make quality decisions.
This is a fulltime position (40 hours per week) Monday – Friday. You'll enjoy the flexibility to telecommute from anywhere within the United States. Training will be conducted virtually from your home.Responsibilities:
This list does not represent all responsibilities for this position.
Candidate must understand and be willing and able to assume roles and responsibilities other than these to meet the needs of MedReview Operations in general.
Serves as a knowledge expert and maintains up to date working knowledge of pricing guidelines in order to act as a resource for all pricing team members.
Responsible for reviewing data in the review application and client claim processing system, and comparing with corresponding UB, medical record or other documentation.
Responsible for reviewing all necessary documentation as necessary to determine appropriate reimbursement for a claim.Responsible for reviewing adjudication software system's claim and line items for determination of how to price a claim / line item.
Possess ability to work at a computer for extended periods.Performs quality reviews on individual team members ensuring all claims are completed timely and per department standards.
Identifies education needs within the department to facilitate pricing accuracy improvement.
Works collaboratively with Assistant Director of Pricing to analyze and optimize processes to maintain acceptable productivity rates for each individual team member.
Works collaboratively with Assistant Director in developing educational tools for new hire orientation and ongoing department education.Other duties as assigned.
Qualifications:
Associates degree preferred.
Minimum of 5 years management experience
Minimum of 5 years related work experience. Prior experience with claim adjudication systems, grouping and pricing software, and other claim adjudication and claim pricing systems. Ie; Facets, Cosmos, CAS, WebStrat, Encoder.
Experience with pricing reject resolution
Basic knowledge of medical terminology.
Good knowledge of Microsoft Word, Excel and Outlook
Intermediate mathematics aptitude
Good communication skills
Good organizational abilities
Good comprehension capabilities
Ability to prioritize multiple tasks
Experience with UB/institutional claims
Knowledge of Medicare and Medicaid billing & payment and coverage guidelines
Strong experience in the analysis and processing of claims, quality assurance, CMS payment methodologies (i.e., DRGs, Cost Outliers)
Must be able to work with minimal supervision
Creative thinker with good skills at problem resolution specifically related to healthcare claim adjudication
High speed internet (300 Mbps per person recommended) with secured WIFI.
Benefits and perks include:
Healthcare that fits your needs