Pricing Configuration Specialist

3 days ago


Hyderabad, Telangana, India beBeeFacetsBenefits Full time ₹ 6,00,000 - ₹ 8,00,000

We are seeking a talented professional to join our team in creating innovative solutions for the world's leading companies. The ideal candidate will collaborate with colleagues from diverse backgrounds to develop cutting-edge products that enhance flexibility, innovation, and success.

The successful applicant will bring deep expertise in configuring pricing modules, focusing on provider contracting, claims adjudication, and benefit/pricing plan setup. A strong understanding of the healthcare domain and hands-on experience with benefit/pricing and network configuration within the Facets platform are essential.

This role requires a Bachelor's degree or equivalent qualification with a minimum of 3-6 years of relevant experience in Facets Benefits or Pricing Configurations and Claim Validation. Strong knowledge in API testing and EDI 278 transactions is required. Additionally, hands-on experience in SQL database testing and proficiency in setting up and managing NetworX Pricer, Benefit Plans, and related configuration components are necessary.

The selected candidate will collaborate with Provider Contracting teams to translate business rules into system configuration, analyze and support Claims Adjudication processes related to benefits or pricing discrepancies or escalations, ensure compliance with Medicare, Medicaid, and commercial payer guidelines, and participate in testing and validation of benefits or pricing setups to ensure accurate claim outcomes.

Document configuration changes and maintain audit-ready records. Work closely with cross-functional teams including IT, business analysts, and QA to implement and troubleshoot system changes.



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