4 days old

Revenue Cycle Specialist Irving TX

Irving, TX 75060
  • Job Code
No industry is moving faster than health care. And no organization is better positioned to lead health care forward. We need attention to every detail with an eye for the points no one has considered. The rewards for performance are significant. You'll help improve the health of millions. And you'll do your life's best work.(sm)

This position requires a full and complete understanding of Commercial Fee for Service Contracts including but not limited to understanding Payer Fee Schedules including Carve-Out Agreements, Payer Language and Payer Management. This position must also be familiar with management of the Charge Master to ensure Charges are set at rates to maximize fee for service reimbursements. This position must also have a solid understanding of the Fee for Service Revenue Cycle as this position will partner with Revenue Cycle and Payers to work through claim payment issues that arise including but not limited to underpayments, denials and appeal denials. The position must cultivate relationships with internal and external stakeholders.

This position has overall responsibility for maintenance the organization's Charge Master and Contract Modules including off-cycle, quarterly and annual updates.   This position also works with all areas of the group practice including central business office, primary care and specialty practice sites, practice operations team, ancillary businesses, information technology, coding, credentialing and finance to ensure payer agreements are adhered to. 

Primary Responsibilities
  • Manage the process to add new CPTs to the Practice Management System & EMR
  • Manage the implementation on new Commercial FFS Contracts
  • Work with Payers to Obtain Fee Schedules
  • Load Fee Schedules into our Practice Management System (NextGen) and Revenue Mgmt tool
  • Research Claim Denials / Payer Issues
  • Work with the Revenue Cycle team and Payers to address all Payer Issues
  • Function as SME on Contract Structure / Reimbursement Methodology
  • Ensure payer compliance with revenue terms of FFS based payer contracts by directing and managing all aspects of revenue integrity activities relating to FFS payer contracts (-short pay-)
  • Work closely with contracting team to pursue findings with payers
  • Achieve optimal performance in managing the Charge Master and Contract Management Modules
  • Actively participate as member of the revenue cycle team to ensure revenue integrity
  • Work collaboratively as a member of the revenue cycle team. Facilitates effective cross-functional working relationship with central office, practice, ancillary and ancillary staff 
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.



Posted: 2020-06-29 Expires: 2020-07-29

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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Revenue Cycle Specialist Irving TX

UnitedHealth Group
Irving, TX 75060

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