Price Transparency Specialist
- Serves as a primary point of contact for clients during onboarding and implementation of price transparency tools.
- Gathers, reviews, and organizes payer data including plan documents, fee schedules, and benefit summaries.
- Maps insurance plans including deductibles, copays, coinsurance, and out-of-pocket maximums into internal systems or templates.
- Identifies, analyzes and executes on payer trends across markets and clients’ patterns in coverage, reimbursement, and patient cost-sharing.
- Collaborates with internal teams (Billing, Software Product Management, Compliance, Client Support) to ensure accurate configuration and delivery of cost estimation.
- Conducts quality assurance checks on payer data and benefit mappings to ensure accuracy and consistency.
- Provides insights and recommendations to clients based on payer data analysis and market trends.
- Supports compliance with Centers for Medicare and Medicaid Services (CMS) price transparency regulations and client-specific reporting needs.
- Troubleshoots backend issues related to plan configuration, data mismatches, or estimation errors.
- Documents system configurations, workflows, and technical requirements for internal and external stakeholders.
- Responsible for behaving in a professional manner both internally and externally in relationships that positively impact the company's reputation and comply with the company's policies and practices. Responsible for being accountable and committed to demonstrating Breg’s cultural beliefs and achieving the key results of the company.
- Responsible for promoting Breg's culture within the organization using established tools such as storytelling, providing focused feedback, and recognition. The performance of the position is aligned with the culture of commitment and accountability, following the steps of: See it, Own it, Solve it, and Do it.
- Collaborate with cross-functional teams to drive excellence in patient care and business solutions.
- Bachelor’s degree is preferred.
- 2+ years of experience in health insurance, payer relations, revenue cycle, or healthcare consulting is required.
- 2+ years of experience working with payer portals, benefit verification tools, healthcare pricing platforms and data analysis tools are required.
- Strong understanding of health insurance plans, eligibility, and cost-sharing structures is required.
- Excellent communication and client-facing skills are required.
- Ability to interpret payer documentation and translate it into structured formats is required.
- Strong organizational skills and attention to detail is required.
- Experience with healthcare data formats is preferred.
- Familiarity with CMS price transparency rules and the No Surprises Act is preferred.
- Background in clinic, hospital, health system, supplier or payer-side operations is preferred.
- Computer proficient to include web browser/internet search, MS Outlook, Word, and Power Point capabilities. Technical competence includes the ability to learn new software and systems and proficiency in Excel is required.
- Experience with Oracle, Customer Relations Management (CRM), and Power Business Intelligence (BI) is preferred.
- A passion for innovation and a commitment to Breg’s mission to Keep Moving Forward.
- Comprehensive Benefits: Medical, dental, vision, disability, and life insurance, effective the first of the month after hire.
- Work-Life Balance: Paid Time Off (PTO) and company-paid holidays.
- Growth & Development: Opportunities for professional advancement within a company that values your contributions.
- Commitment to Diversity & Inclusion: Breg is proud to be an Equal Employment Opportunity employer, fostering a diverse and inclusive workplace.
- For more information regarding Company benefits, please see
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