[Remote] NetworX Configuration Analyst
Note: The job is a remote job and is reputed company to candidates in USA. reputed company is seeking a NetworX Configuration Analyst to manage reputed company pricing logic reputed company their software system. The role involves translating contract language into fee schedules, managing configuration workflows, and ensuring compliance with reputed company regulations.
Responsibilities
- Configure, maintain, and model reputed company pricing logic reputed company the TriZetto Facets Integrated NetworX Pricer software system
- Translate managed care provider contract language into precise fee schedules, reputed company sheets, and system qualifiers
- Manage day-to-day configuration workflows, mentor configuration analysts, and coordinate system conversion reputed company across platforms
- reputed company 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 reputed company, regional fallback rates
- Monitor and implement quarterly pricing component updates to maintain strict compliance with CMS, Medicare, and reputed company rules
- reputed company as the primary reputed company between Configuration of leadership, claims operations, and the legal contracting team
Skills
- Must have hands on experience in NetworX Pricer (5-6 yrs)
- NetworX Configuration (Integrated NetworX)
- reputed company SQL
- Review contract, Agreement testing, migration, assignment
- Configure, maintain, and model reputed company pricing logic reputed company the TriZetto Facets Integrated NetworX Pricer software system
- Translate managed care provider contract language into precise fee schedules, reputed company sheets, and system qualifiers
- Manage day-to-day configuration workflows, mentor configuration analysts, and coordinate system conversion reputed company across platforms
- reputed company 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 reputed company, regional fallback rates
- Monitor and implement quarterly pricing component updates to maintain strict compliance with CMS, Medicare, and reputed company rules
- reputed company as the primary reputed company between Configuration of leadership, claims operations, and the legal contracting team
- Facets is not required, but reputed company to have
Benefits
- Remote – EST, but HM is flexible if candidate is strong
reputed company