Careers at Gratiture Solutions, LLC.
JOB TITLE: NetworX Configuration Analyst – Healthcare Payer
JOB DESCRIPTION: We are seeking an experienced NetworX Configuration Analyst with strong expertise in NetworX Pricer, NetworX Modeler, FACETS, provider contract pricing, and claims adjudication. The ideal candidate will have hands-on experience configuring provider reimbursement rules, fee schedules, qualifier groups, and pricing methodologies within healthcare payer environments.
Key Responsibilities:
- Configure and maintain provider contracts, fee schedules, qualifier groups, and reimbursement methodologies in NetworX.
- Translate provider contract terms and business requirements into accurate system configurations.
- Perform pricing validation, claims analysis, configuration testing, and production support.
- Investigate and resolve pricing discrepancies, reimbursement errors, and claims adjudication issues.
- Work closely with Provider Contracting, Claims Operations, Business, and IT teams.
- Support UAT, regression testing, configuration migrations, and production releases.
- Maintain configuration documentation, business rules, and change records.
- Ensure accurate provider reimbursement across Commercial, Medicare, and Medicaid products.
JOB LOCATION: Remote – New York City metropolitan area
QUALIFICATIONS:
Must-Have Skills
- NetworX Pricer and NetworX Modeler – hands-on experience mandatory.
- FACETS configuration and claims adjudication experience.
- Strong experience with provider contract configuration and reimbursement pricing.
- Advanced SQL for data analysis, validation, and troubleshooting.
- Strong Healthcare Payer domain experience across Commercial, Medicare, and/or Medicaid.
- Experience with claims pricing validation, defect resolution, and production support.
- Ability to interpret complex provider contracts and translate them into pricing configurations.
Preferred Skills
- Experience with fee schedules and various provider reimbursement methodologies.
- CMU migrations and configuration deployment experience.
- Provider Contracting and Claims Operations experience.
- Knowledge of EDI 837/835 transactions.
- Experience supporting large-scale healthcare payer transformation initiatives.
EMPLOYER: Gratiture Solutions, LLC.
INDUSTRY: Healthcare Payer / Health Insurance
EMPLOYMENT TYPE: Contract (W-2 with Gratiture Solutions, LLC.)
PAY RATE: $60.00/hour (W-2).
HOW TO APPLY: Send resumes to: HR, Gratiture Solutions, LLC., 12800 Westridge Blvd., Suite 152, Frisco, TX 75035 or contactusa@gratiture.us
Gratiture Solutions, LLC. is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, veteran status, or any other characteristic protected by law.