Transplant Specialist, Revenue Cycle

UT Southwestern Medical Center • Dallas, TX

21h • Remote

About The Position

The Revenue Cycle Department has a new opportunity available for the role of Transplant Specialist. Currently there are five team members who report to the supervisor/manager. This position works under general supervision to handle contracting and operational functions for transplant contracts. The daily responsibilities in this role will include, but not be limited, to the following:
Overseeing and completing all processes related to transplant case rate allocations including reporting functions, charge analysis with contract review, application of Medicare formula for allocation development, check requests for community providers and coordinating with hospital and physician follow up teams.
All duties require understanding, interpretation, and application of contract parameters to complete.
Reviewing patient referrals/updates within EPIC registration/bundled episodes and transplant access database.
Reviewing charges in EPIC to ensure billing on correct guarantor account type/coverage.
Experience working with transplant programs including, but not limited to transplant contracting, transplant provider relations, transplant billing, and collections, etc.
Must be able to multi-task and pivot across duties as needed.
Interact with a variety of internal and external customers i.e., clinics, hospitals programs, billing/collections teams for physicians, payers, transplant network, etc.
Shift: 7am-4pm or 8am-5pm
Work from home (WFH): This is a WFH position. The applicant must live within the state of Texas, the DFW area (within 50 miles) preferred. Additional details related to this shall be discussed as part of the interview process.

Requirements

• 5 years experience in the health care industry
• At least three (3) years in managed care contracting/provider relations or revenue cycle.
• Experience working with transplant programs including, but not limited to transplant contracting, transplant provider relations, transplant billing, and collections, etc.
• Must be able to multi-task and pivot across duties as needed.
• Interact with a variety of internal and external customers i.e., clinics, hospitals programs, billing/collections teams for physicians, payers, transplant network, etc.
• Applicant must live within the state of Texas, the DFW area (within 50 miles) preferred.

Nice To Haves

• Bachelor's degree in business administration, Hospital Administration, or related field.
• Transplant program experience

Responsibilities

• Overseeing and completing all processes related to transplant case rate allocations including reporting functions, charge analysis with contract review, application of Medicare formula for allocation development, check requests for community providers and coordinating with hospital and physician follow up teams.
• Understanding, interpretation, and application of contract parameters to complete duties.
• Reviewing patient referrals/updates within EPIC registration/bundled episodes and transplant access database.
• Reviewing charges in EPIC to ensure billing on correct guarantor account type/coverage.
• Managing and maintaining transplant patients' referrals and updates throughout the transplant process via internal Access database and Epic Resolute including insurance coverage and charge review for proper billing.
• Coordinating case rate distributions for patients covered under case rate or global payments.
• Conducting payment audits on transplant patient accounts working closely with Revenue Cycle and Revenue Accounting.
• Acting as an intermediary between Revenue Cycle and Transplant Network.
• Performing reporting functions and data analysis as needed.
• Performing other duties as assigned.

Benefits

• PPO medical plan, available day one at no cost for full-time employee-only coverage
• 100% coverage for preventive healthcare-no copay
• Paid Time Off, available day one
• Retirement Programs through the Teacher Retirement System of Texas (TRS)
• Paid Parental Leave Benefit
• Wellness programs
• Tuition Reimbursement
• Public Service Loan Forgiveness (PSLF) Qualified Employer

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree