Business Operations & Reimbursement Manager >>>

Tulane University      Office of Human Resources

Description for Job:   IRC33804
Business Operations & Reimbursement Manager
TUMG CEO
Location:  Harahan, LA
Summary
Responsible for maintaining TUMG Master Fee Schedule, tracks payer fee schedule updates and coordinates with vendors to ensure timely and accurate uploads and performing in-depth payer reimbursement and variance analysis, supporting payer negotiations, and advising on strategic pricing decisions. This role ensures contract compliance, coordinates with A/R team to resolve over/underpayments, and supports efforts to optimize revenue cycle operations and reimbursement accuracy through collaboration with internal teams, payor relations, and third-party vendors.
Required Knowledge, Skills, and Abilities
• Deep understanding of managed care, government contracts, and reimbursement processes.
• Strong data analysis skills with the ability to compile and interpret complex data sets related to contract compliance and payment trends. 
• Excellent communication and interpersonal skills for working with internal teams and external payer representatives.
• Extensive knowledge of medical coding systems (ICD, CPT, HCPCS, etc.) and payer fee schedules.
• Ability to maintain confidentiality in all work performed.
• Excellent organizational and time management skills; ability to effectively manage multiple tasks simultaneously and meet established deadlines.
• Excellent skills using MS Word, Excel, and PowerPoint 
Required Education and/or Experience
• Bachelor’s Degree with two (2) years’ experience in revenue cycle management, medical coding, and payer payment variances.
Preferred Qualifications
• Master’s Degree: minimum four (4) years’ experience in healthcare setting preferred.
• Demonstrated proficiency in the utilization of Data Visualization tools such as Power BI.
• Experience with hospital or clinical charge description master (CDM) and payer fee schedules; knowledge of global fees, professional fees, and technical fees; experience in medical billing, collections, and coding practices and procedures.
Compensation Information
This position is classified as "exempt, salaried" and is assigned to pay grade null. Tulane offers a variety of options to enhance your health and well-being so that you may enjoy more out of life now and in the future. Learn more about Life at Tulane as well as our Benefits and Pay . See our Candidate Resources to learn more about our hiring process and what to expect.
How to Apply
 
This position will close on the date it is filled
 
Please Note: Depending on your role and the department in which you work, you may be expected to adhere to COVID-19 requirements, such as vaccinations and booster shots.
 
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Tulane University is an equal opportunity educator and employer committed to providing an education and employment environment free of unlawful discrimination, harassment, and retaliation.   Legally protected demographic classifications (such as a person’s race, color, religion, age, sex, national origin, shared ancestry, disability, genetics, veteran status, or any other characteristic protected by federal, state, or local laws) are not relied upon as an eligibility, selection or participation criteria for Tulane’s employment or educational programs or activities.
 
Tulane University is responsible for providing reasonable accommodations to individuals with disabilities throughout the applicant screening process. If you need assistance in completing an application or during any phase of the interview process, please contact the Office of Human Resources by phone at 504-865-4748 or by email at hr@tulane.edu .
 
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