Pricing Specialist I (Health Insurance Claims)

HMA is the premier third-party health plan administrator across the PNW and beyond. We relentlessly deliver on our promise to provide medium to large-size employers with customized health plans. We offer various high-quality, affordable healthcare plan options supported with best-in-class customer service.
We are proud to say that for four years, HMA has been chosen as a 'Washington's Best Workplaces' by our Staff and PSBJ™. Our vision, 'Proving What's Possible in Healthcare™,' and our values, People First!, Be Extraordinary, Work Courageously, Own It, and Win Together, shape our culture, influence our decisions, and drive our results.
What we are looking for: We are always searching for unique people to diversify our team. We only hire people that care deeply about others, thrive in evolving environments, gain satisfaction from being part of a team, are motivated by tackling complex challenges, are courageous enough to share ideas, action-oriented, resilient, and results-driven.
What you can expect: You can expect an inclusive, flexible, and fun culture, comprehensive salary, pay transparency, benefits, and time off package with plenty of personal development and growth opportunities. If you are looking for meaningful work, a clear purpose, high standards, work/life balance, and the ability to contribute to something important, find out more about us at: https://www.accesshma.com/
How YOU will make a Difference:
The Pricing Specialist I will work collaboratively with a team and assist with setting and maintaining provider and customer pricing, pricing issue resolution and coordination of benefits. Partners with management to analyze pricing data and improve pricing processes and methodologies. Partners with management to administer coordination of benefits processing, resolution and related process improvement. Your role will be central in contributing to the overall operational excellence in the pricing of claims and coordination of benefits.
What YOU will do:

• Customer and Provider relationship management: Quickly responds to and effectively manages claims pricing inquiries
• Business knowledge: Demonstrates operational business and claims pricing subject matter expertise
• Analytical and critical thinking: Performs analytics to determine financial impacts and pricing methodologies
• Trainer/Auditor: Ability to train and effectively audit pricing activities internally and with vendor staff
• Analysis & reporting: Prepares financial analysis reporting and summarizes findings for management
• Team oriented: Works well as part of a solutions team, sharing ideas, supporting intended outcomes
• Customer response: Effectively responds to internal and external customer inquiries and focuses on issue resolution
• Critical thinking and troubleshooting: Ability to identify issues, recommend solutions, and manage situations to resolution
• Industry knowledge: Ability to research and discover cost savings, risks and trends that benefit the customer and HMA
• Customer and HMA Coordination of Benefits: Ensures that health plan payer hierarchy is maintained for HMA and RGA plans by identifying and maintaining all third party and coordination of benefits information through effective communication plans

Knowledge, Experience, and Key Attributes needed for Success:

• High School Diploma required
• 1-3 years of claims processing, pricing and coordination of benefits experience
• Strong interpersonal and communication skills
• Attention to detail, with high degree of accuracy and urgency
• Ability to take initiative and ownership of assigned tasks, working independently with minimal supervision, yet maintain a team-oriented and collaborative approach to problem solving
• Experience working with multiple systems and applications
• Demonstrated track record of success in a fast-paced environment

Compensation:The base salary range for this position in the greater Seattle area is $50,000 ($24/hr) - $54,000 ($26/hr) and varies dependent on geography, skills, experience, education, and other job or market-related factors. Performance-based incentive bonus(es) is available.
Disclaimer: The salary, other compensation, and benefits information are accurate as of this posting date. HMA reserves the right to modify this information at any time, subject to applicable law.
In addition, HMA provides a generous total rewards package for full-time employees that includes:

• Seventeen (IC) days paid time off (individual contributors)
• Eleven paid holidays
• Two paid personal and one paid volunteer day
• Company-subsidized medical, dental, vision, and prescription insurance
• Company-paid disability, life, and AD&D insurances
• Voluntary insurances
• HSA and FSA pre-tax programs
• 401(k)-retirement plan with company match
• Annual $500 wellness incentive and a $600 wellness reimbursement
• Remote work and continuing education reimbursements
• Discount program
• Parental leave
• Up to $1,000 annual charitable giving match

How we Support your Work, Life, and Wellness Goals
At HMA, we believe in recognizing and celebrating the achievements of our dedicated staff. We offer flexibility to work schedules that support people in all time zones across the US, ensuring a healthy work-life balance. Employees have the option to work remotely or enjoy the amenities of our renovated office located just outside Seattle with free parking, gym, and a multitude of refreshments. Our performance management program is designed to elevate career growth opportunities, fostering a collaborative work culture where every team member can thrive. We also prioritize having fun together by hosting in person events throughout the year including an annual all hands, summer picnic, trivia night, and a holiday party.
We hire people from across the US (excluding the state of Hawaii and the cities of Los Angeles and San Francisco.)
HMA requires a background screen prior to employment.
Protected Health Information (PHI) Access Healthcare Management Administrators (HMA); employees may encounter protected health information (PHI) in the regular course of their work. All PHI shall be used and disclosed on a need-to-know-basis and according to HMA's standard policies and procedures.
HMA is an Equal Opportunity Employer.
For more information about HMA, visit www.accesshma.com .