Repricing Coordinator

Point C is a National third-party administrator (TPA) with local market presence that delivers customized self-funded benefit programs. Our commitment and partnership means thinking beyond the typical solutions in the market to do more for clients and take them beyond the standard Point A to Point B. We have researched the most effective cost containment strategies and are driving down the cost of plans with innovative solutions such as network and payment integrity pharmacy benefits and care management. There are many companies with a mission. We are a mission with a company.

• Review and reprice medical claims using contracted provider network rates
• Apply appropriate discounts based on PPO rental networks and client agreements
• Validate billed charges against fee schedules and contract terms
• Identify pricing discrepancies and escalate issues when necessary
• Communicate with internal teams regarding claim status and pricing questions
• Maintain accurate documentation and notes within claims systems
• Meet productivity and accuracy standards
• Follow HIPAA and data privacy guidelines at all times

• High school diploma or equivalent required; associates degree or coursework in healthcare business or related field a plus
• No prior healthcare or claims experience required (training provided)
• Strong attention to detail and accuracy
• Basic computer skills and comfort using multiple systems
• Ability to interpret contracts and follow written guidelines
• Good organizational and time-management skills
• Professional written and verbal communication skills

• Exposure to medical billing insurance or claims processing
• Familiarity with CPT codes or medical terminology
• Experience working in an office or administrative environment

• Comprehensive training and onboarding
• Opportunities for growth within claims repricing or operations
• Supportive team environment
• Competitive entry-level pay and benefits package

• Comprehensive medical dental vision and life insurance coverage
• 401(k) retirement plan with employer match
• Health Savings Account (HSA) & Flexible Spending Accounts (FSAs)
• Paid time off (PTO) and disability leave
• Employee Assistance Program (EAP)

Equal Employment Opportunity: At Point C Health we know we are better together. We value respect and protect the uniqueness each of us brings. Innovation flourishes by including all voices and makes our businessand our societystronger. Point C Health is an equal opportunity employer and we are committed to providing equal opportunity in all of our employment practices including selection hiring performance management promotion transfer compensation benefits education training social and recreational activities to all persons regardless of race religious creed color national origin ancestry physical disability mental disability genetic information pregnancy marital status sex gender gender identity gender expression age sexual orientation and military and veteran status or any other protected status protected by local state or federal law.