Payor Relations & Reimbursement Manager

Payor Relations & Reimbursement Manager

Join to apply for the Payor Relations & Reimbursement Manager role at Tulane University.

Responsible for maintaining TUMG Master Fee Schedule, tracking payer fee schedule updates and coordinating with vendors to ensure timely and accurate uploads; performing in-depth payer reimbursement and variance analysis, supporting payer negotiations, and advising on strategic pricing decisions. This role ensures contract compliance, coordinates with the 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.

• 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.

• Bachelor’s Degree with two (2) years’ experience in revenue cycle management, medical coding, and payer payment variances.

• 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.

• Entry level

• Full-time

• Finance and Sales
• Industries:
  Higher Education

Referrals increase your chances of interviewing at Tulane University by 2x.

Apply BELOW