Remote Managed Care Reimbursement Coordinator

Description Become part of an inclusive organization with over 40,000 teammates, whose mission is to improve the health and well-being of the unique communities we serve. Ideal Candidate Epic Hospital Billing or Professional Billing Expected Reimbursement Contracts Administration certification or similar proficiency in other vendor software. Overall general understanding of Healthcare Revenue Cycle processes. Epic Hospital Billing Experience or similar in other vendor software. Specifics as follows: Resolving insurance payment variances Understanding of insurance payer reimbursement terms and billing to support Strong understanding of insurance payment process/posting of payer remittance information Summary The Managed Care Coordinator is a key member of the Contract Administration team. This role is responsible for maintaining accurate reimbursement calculations, performing payment variance analysis, supporting ad‑hoc reporting needs, and assisting with contract modeling and negotiation activities. The position plays an important role in ensuring payer contracts are accurately reflected in billing systems and that financial outcomes align with contractual expectations. Responsibilities Billing Reimbursement Configuration and Maintenance Build, maintain, and troubleshoot expected Hospital, ASC, and Ancillary reimbursement calculations within Epic for both governmental and commercial payers. This includes ensuring that reimbursement logic is accurately loaded and aligned between Epic and payer systems. Responsibilities include implementing routine updates such as quarterly drug fee schedules, annual payer rate increases, and annual fee schedule updates. Technical capabilities include building contracts in the Epic POC environment and utilizing Content Manager for data couriering to PRD. The role requires obtaining the Epic RHB390 Hospital Billing Expected Reimbursement Contracts certification within the first 90 days. Contract Modeling and Negotiation Support Support major payer negotiations by developing and analyzing contract modeling scenarios. Using Managed Care–developed tools, proposed commercial payer rates are modeled across all UNC Health entities to assess expected financial impact. Results are summarized and presented to financial and operational leadership to support data‑driven decision‑making. Contract Validation and Variance Analysis Validate contract builds by performing payment variance analysis to ensure contracted reimbursement terms are correctly implemented and functioning as expected. Identify discrepancies and collaborate with internal teams to resolve issues. Other Information Education Requirements Bachelor’s degree in relevant field Licensure/Certification Requirements No licensure or certification required. Professional Experience Requirements Requires two (2) years of experience with managed care contracts and provider relations if a Bachelor’s degree; six (6) years if an Associate’s degree; ten (10) years if a high school diploma or GED; zero (0) years if a Master’s degree. Knowledge/Skills/and Abilities Requirements — Job Details Legal Employer: NCHEALTH Entity: Shared Services Organization Unit: Managed Care Work Type: Full Time Standard Hours Per Week: 40.00 Salary Range: $28.87 - $41.50 per hour (Hiring Range) Pay offers are determined by experience and internal equity Work Assignment Type: Remote Work Schedule: Day Job Location of Job: US:NC:Morrisville Exempt From Overtime: Exempt: Yes This position is employed by NC Health (Rex Healthcare, Inc., d/b/a NC Health), a private, fully‑owned subsidiary of UNC Health Care System, in a department that provides shared services to operations across UNC Health Care; except that, if you are currently a UNCHCS State employee already working in a designated shared services department, you may remain a UNCHCS State employee if selected for this job. Qualified applicants will be considered without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, genetic information, disability, status as a protected veteran or political affiliation. UNC Health makes reasonable accommodations for applicants' and employees' religious practices and beliefs, as well as applicants and employees with disabilities. All interested applicants are invited to apply for career opportunities. Please email View email address on click.appcast.io if you need a reasonable accommodation to search and/or to apply for a career opportunity. #J-18808-Ljbffr Academy of Managed Care Pharmacy