Payer Contract Specialist - Revenue Cycle

Location

Type, TX | United States

Job description

JOB SUMMARY:

The Revenue Cycle Department – Quality Assurance team has a new opportunity available for the role of Payer Contract Specialist. Among the advanced skills the ideal candidate should possess includes the following: 

• Contract Management through EPIC software of various Government and Commercial Payors. 
• Payor Relations work to maintain communication and distribution of information to ensure timely amendments to our process to comply with payor policy changes. 
• Reimbursement analysis through escalations and relations with Patient Financial Services, utilizing data from EPIC databases. 

Shift: 8-hour days flex shift

Work From Home (WFH): This position will be a work from position. Additional details related to this shall be discussed as part of the interview process.

Quick tip(s):

• Please review the section entitled experience/education and focus on the job requirements.
• Make sure you include the experience listed under the requirements section on your application.

Why UT Southwestern?

With over 75 years of excellence in Dallas-Fort Worth, Texas, UT Southwestern is committed to excellence, innovation, teamwork, and compassion. As a world-renowned medical and research center, we strive to provide the best possible care, resources, and benefits for our valued patients and employees. With over 20,000 employees, we are committed to continuing our growth with the best professionals in the healthcare industry. We invite you to be a part of the UT Southwestern team where you’ll discover teamwork, professionalism, and consistent opportunities for growth.

EXPERIENCE | EDUCATION:

REQUIRED:

• Bachelor’s degree in Health Care Administration, or equivalent
• And two (2) years’ experience in areas such as member service, provider relations, contract negotiations, claims and/or billing required.
• Additional years’ related experience may be considered in lieu of education. 

JOB DUTIES:

• Acts as a contact on Managed Care contractual or global billing inquires received by Contract Administration. Resolves or routes issues to appropriate parties. Escalates issues as needed internally.
• Supports supervisor or lead in educational sessions, meetings, or conference calls for internal and external constituents as to access to Contract Administrative services. 
• Supports external contract with Underpayment Vendor for Revenue Cycle management by fielding contractual, fee schedules or global trends issues. Refers relationship issues to the Senior Specialist. 
• Researches potential contract and reimbursement issues and changes by organizing activities, reviewing data analyses and reports to support internal and external operating meetings. Queries managed care organizations for contract clarification of medical and reimbursement policies with direction from supervisor or lead. 
• Performs policy analysis for managed care issues by reviewing contracts, reviewing reports/financial data, and analyzing fee schedules and coding; ensures contracts are administered to reflect appropriate business decisions.
• Performs other duties as assigned. 

SECURITY: 

This position is security-sensitive and subject to Texas Education Code 51.215, which authorizes UT Southwestern to obtain criminal history record information.

UT Southwestern Medical Center is committed to an educational and working environment that provides equal opportunity to all members of the University community. As an equal opportunity employer, UT Southwestern prohibits unlawful discrimination, including discrimination on the basis of race, color, religion, national origin, sex, sexual orientation, gender identity, gender expression, age, disability, genetic information, citizenship status, or veteran status.

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