[Hiring] Architect @Apolisrises

Role Description

We are seeking a NetworX Configuration Analyst to support provider contract pricing, reimbursement configuration, and claims adjudication within the NetworX Pricing platform. The ideal candidate will have strong healthcare payer experience, expertise in NetworX and FACETS, and the ability to translate provider contract requirements into accurate pricing configurations.

Qualifications

• NetworX Pricer and NetworX Modeler experience.
• Provider contract and reimbursement configuration experience.
• Experience with fee schedules, pricing methodologies, and network reimbursement.
• FACETS configuration and claims adjudication knowledge.

Requirements

• Configure and maintain provider contracts, fee schedules, qualifier groups, and reimbursement methodologies in NetworX.
• Analyze business and contractual requirements and convert them into system configurations.
• Perform pricing validation, claims analysis, testing, and production support.
• Investigate and resolve pricing, reimbursement, and claims adjudication issues.
• Collaborate with Provider Contracting, Claims, Business, and IT teams to implement configuration changes.
• Support UAT, production releases, and post-implementation validation activities.
• Create and maintain configuration documentation and testing evidence.