Medicaid Pricer Regulatory Analyst
Core
Entry-level analyst supporting senior teams in Medicaid reimbursement research, pricing logic updates, and data validation for healthcare payment systems.
Role type
Entry-level regulatory pricer analyst
Builds
Medicaid pricing logic and configuration
Domain
Healthcare reimbursement and regulatory compliance
Deliverable
production ML models | product features | dashboards & analysis
Required skills
Medicaid regulations research, data entry, procedural documentation, Excel formulas/lookups, claims adjudication process knowledge, claim editing rules interpretation
Preferred skills
MS SQL Server Studio, Certified coder (CCS/CCS-P/CPC), RHIA/RHIT, RN/LPN with coding knowledge
Technologies
Excel, MS SQL Server Studio
Responsibilities
Perform basic research on Medicaid regulations and fee schedules, maintain pricing logic and configuration via data entry, draft or update procedural documentation and SOPs, conduct data comparisons and validation using Excel, execute test cases for system testing, collaborate with Development and QA teams
Seniority
Entry-level, foundational support role