Pricing and Reimbursement Analyst
Company: ALTA IT Services
Location: Dayton
Posted on: June 28, 2025
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Job Description:
Job Title: Pricing and Reimbursement Analyst Location: Dayton,
Ohio Type: Contract Compensation: Contractor Work Model: Remote
Title: Pricing and Reimbursement Analyst ALTA is supporting an
8-month contract opportunity working 100% remote. 2 roles are open.
ALTA IT Services is a wholly owned subsidiary of System One, a
leading provider of specialized workforce solutions and integrated
services. ALTA is an established leader in IT Staffing and
Services, for both government and commercial enterprises across the
United States, specializing in Program & Project Management,
Application Development, Cybersecurity, Data & Advanced Analytics,
and Agile Transformation Services. Here is what we are looking for
in a Pricing and Reimbursement Analyst: Someone with a background
in researching and developing the configuration requirements for
Facets/NetworXPricer agreements, associated with Medicaid fee for
service provider contracts. This means researching State Medicaid
fee schedule requirements, Administrative Code and State Plan
documents, State provider manuals, and other materials to be able
to define how the State Medicaid agencies pay their providers and
turning that into detailed code-level agreement requirements
(procedure code, revenue code, DRG code, place of service code,
etc.) to be configured into the system. Extensive knowledge of
end-to-end claims lifecycle, from intake and encounter submission
to adjudication routines and reimbursement. Hands-on experience
with provider network contracting, including in-depth knowledge of
reimbursement methodologies, including fee-for-service, DRG, per
diem, capitation and value-based payment models. Familiarity with
regulatory requirements across Medicare and Medicaid line of
business – especially state-specific Medicaid rules & regulations.
Experience with interpreting contract terms and amendments,
including scope of services, rate structures, and regulatory
compliance language. Knowledge of provider types and market
dynamics, including hospitals, physicians, ancillary services,
behavioral health, LTSS and others. Ability to work independently
in a fast-paced environment, consistently identifying and
implementing solutions to complex problems with no established
protocols. Demonstrate strong communication skills to lead and
facilitate cross-functional group discussions, ensuring alignment
among diverse stakeholders as well as providing clear guidance and
subject matter expertise to support collaborative problem-solving
and decision-making. For immediate consideration please contract
Patrick Jackson at pjackson@altaits.com System One, and its
subsidiaries including Joulé, ALTA IT Services, and Mountain Ltd.,
are leaders in delivering outsourced services and workforce
solutions across North America. We help clients get work done more
efficiently and economically, without compromising quality. System
One not only serves as a valued partner for our clients, but we
offer eligible employees health and welfare benefits coverage
options including medical, dental, vision, spending accounts, life
insurance, voluntary plans, as well as participation in a 401(k)
plan. System One is an Equal Opportunity Employer. All qualified
applicants will receive consideration for employment without regard
to race, color, religion, sex (including pregnancy, childbirth, or
related medical conditions), sexual orientation, gender identity,
age, national origin, disability, family care or medical leave
status, genetic information, veteran status, marital status, or any
other characteristic protected by applicable federal, state, or
local law. M-PJ1 LI-PJ1 DI-PJ1 Ref: 860-IT Cincinnati
Keywords: ALTA IT Services, Middletown , Pricing and Reimbursement Analyst, Executive , Dayton, Ohio
