What are the responsibilities and job description for the Healthcare Repricing Manager position at RealREPP?
Remote or Philadelphia, PA (Preference for experienced candidates over location)
$80,000 – $110,000 (flexible for strong candidates) Bonus Eligible
About The Role
RealREPP is working with a leading healthcare company to build an in-house repricing and contract integration team. We are seeking a Healthcare Repricing Manager with deep expertise in Medicare reimbursement, hospital contracts, and claims pricing methodologies. This is a key leadership role offering significant career growth potential.
Key Responsibilities
$80,000 – $110,000 (flexible for strong candidates) Bonus Eligible
About The Role
RealREPP is working with a leading healthcare company to build an in-house repricing and contract integration team. We are seeking a Healthcare Repricing Manager with deep expertise in Medicare reimbursement, hospital contracts, and claims pricing methodologies. This is a key leadership role offering significant career growth potential.
Key Responsibilities
- Oversee claims repricing and reimbursement strategies, ensuring alignment with Medicare Fee Schedules and DRG pricing.
- Develop and maintain contract pricing rules for hospital claims and out-of-network reimbursement.
- Lead negotiation and interpretation of payer contracts to optimize reimbursement rates.
- Support Independent Dispute Resolution (IDR) and No Surprises Act (NSA) appeals.
- Implement automation and efficiency improvements in contract pricing workflows.
- Collaborate with legal, compliance, and IT teams to enhance claims pricing processes.
- Provide data-driven insights and reporting on claims performance and reimbursement trends.
- 5 years of experience in healthcare claims repricing, contract negotiation, and Medicare reimbursement.
- Proven ability to read and interpret complex healthcare contracts and apply them to claims systems.
- Expertise in Medicare Fee Schedules, DRG pricing, and hospital reimbursement models.
- Strong data analytics and Excel skills for claims analysis and process improvement.
- Experience with claims processing platforms (Javelina, FACETS, Epic, or similar preferred).
- Leadership skills with a track record of process optimization and strategic decision-making.
- $80,000 – $110,000 base salary (flexible for top candidates) performance bonuses
- Comprehensive benefits package, including:
- Medical, dental, and vision coverage (PPO and HSA options)
- 401(k) with company match
- Telemedicine services at $0 copay
- Dependent care flexible spending account
- Robust voluntary benefits, including life insurance and disability coverage
- Significant upward mobility and leadership opportunities
Salary : $80,000 - $110,000
