Note: The job is a remote job and is open to candidates in USA. Net2Source is an award-winning total workforce solutions company providing staffing solutions globally. The NetworX Pricer Configuration Analyst will configure and maintain healthcare pricing logic, translate provider contracts into system rules, manage testing and conversion workflows, and use SQL to validate configuration data and ensure claims payment accuracy.
Responsibilities
- Configure, maintain, and model complex pricing logic within the Facets Integrated NetworX Pricer software system
- Translate managed care provider contract language into precise fee schedules, rate sheets, and system qualifiers
- Manage day-to-day configuration workflows, mentor configuration analysts, and coordinate system conversion projects across platforms
- Direct comprehensive unit, regression, and end-to-end testing processes to ensure absolute claim payment accuracy
- Utilize advanced SQL queries and relational databases to audit, validate, and troubleshoot massive configuration data batches
- Establish hierarchical system logic to correctly prioritize specific provider agreements over standard, regional fallback rates
- Monitor and implement quarterly pricing component updates to maintain strict compliance with CMS, Medicare, and Medicaid rules
- Act as the primary liaison between Configuration of leadership, claims operations, and the legal contracting team
Skills
- Must have hands on experience in NetworX Pricer experience
- NetworX Configuration (Integrated NetworX)
- Oracle SQL
- Review contract, Agreement testing, migration, assignment
Benefits
- Remote work in the USA
- 11 Months+ hire type
- Weekly pay cycle
Company Overview
Company H1B Sponsorship