Managed Care and Reimbursement Specialist
Fairfax, VA
Full Time
Patient Accounts
Experienced
Managed Care and Reimbursement Specialist
Fairfax Radiology Centers | Hybrid | Full-Time
1–2 Days On-Site Per Week Initially | Potential for Increased Remote Flexibility
This is an Internal Job Posting for Current FRC Employees Only
Make an Impact Beyond the Numbers — Help Strengthen the Business of Patient Care
At Fairfax Radiology Centers (FRC), exceptional patient care depends on more than advanced imaging technology and clinical expertise. Behind every patient experience is a team dedicated to ensuring our services remain accessible, our payer relationships are strong, and our revenue cycle operations run efficiently.
We're seeking a detail-oriented, analytical, and collaborative Managed Care and Reimbursement Specialist to join our Revenue Cycle team.
In this role, you'll play an important part in supporting payer relationships, analyzing reimbursement trends, resolving complex insurance issues, and ensuring payer contracts and reimbursement processes are implemented accurately across our organization.
If you enjoy solving complex problems, digging into data, collaborating across departments, and identifying opportunities to improve financial performance, this is an opportunity to put your expertise to work in a meaningful way.
Why You'll Love Working Here
Managed Care & Payer Relationships
What You'll Bring
Required Qualifications
Why Fairfax Radiology Centers?
As the largest radiology practice in the Washington, DC metropolitan area, Fairfax Radiology Centers is recognized for combining advanced diagnostic imaging technology with exceptional, patient-centered care.
With more than 20 outpatient imaging centers and a team of subspecialized radiologists, we are committed to delivering high-quality imaging services while continually improving the experience for our patients, referring providers, and employees.
Our culture is built on Respect, Trust, Compassion, and Innovation — values that guide how we care for patients and work together as a team.
Whether your role is clinical, operational, or administrative, your contributions matter.
Ready to Make a Difference?
If you're a healthcare revenue cycle professional who enjoys analyzing data, navigating payer complexities, and finding solutions that improve organizational performance, we'd love to learn more about you.
Join Fairfax Radiology Centers and help support the financial operations that make exceptional patient care possible.
Apply today!
Compensation
Based on your qualifications and experience, the compensation range for this position is:
$58,344 - $78,396 annual salary
Placement within the range is determined by factors including experience, education, certifications, and internal equity.
Equal Opportunity Employer
FRC is committed to diversity, equity, and inclusion. We provide equal employment opportunities to all employees and applicants regardless of race, color, age, religion, sex (including pregnancy), sexual orientation, gender identity or expression, national origin, disability, veteran status, genetic information, or any other protected characteristic.
Fairfax Radiology Centers | Hybrid | Full-Time
1–2 Days On-Site Per Week Initially | Potential for Increased Remote Flexibility
This is an Internal Job Posting for Current FRC Employees Only
Make an Impact Beyond the Numbers — Help Strengthen the Business of Patient Care
At Fairfax Radiology Centers (FRC), exceptional patient care depends on more than advanced imaging technology and clinical expertise. Behind every patient experience is a team dedicated to ensuring our services remain accessible, our payer relationships are strong, and our revenue cycle operations run efficiently.
We're seeking a detail-oriented, analytical, and collaborative Managed Care and Reimbursement Specialist to join our Revenue Cycle team.
In this role, you'll play an important part in supporting payer relationships, analyzing reimbursement trends, resolving complex insurance issues, and ensuring payer contracts and reimbursement processes are implemented accurately across our organization.
If you enjoy solving complex problems, digging into data, collaborating across departments, and identifying opportunities to improve financial performance, this is an opportunity to put your expertise to work in a meaningful way.
Why You'll Love Working Here
- Hybrid Work Environment – Initially work on-site just 1–2 days per week, with the potential for increased remote flexibility based on departmental needs.
- Meaningful, Analytical Work – Go beyond routine billing activities to investigate reimbursement challenges, evaluate payer contracts, and identify opportunities to improve revenue performance.
- Cross-Functional Collaboration – Partner with organizational leadership, insurance payers, external billing partners, and internal teams.
- Opportunity to Make an Impact – Your research, analysis, and recommendations will help strengthen reimbursement accuracy, payer relationships, and revenue cycle operations.
- Professional Growth – Expand your knowledge of managed care, payer contracting, reimbursement methodologies, and healthcare financial operations.
- Comprehensive Benefits Package, including:
- Medical, dental, and vision insurance
- Paid time off and holidays
- Tuition and continuing education reimbursement
- Employer-paid short- and long-term disability
- Life insurance
- Profit Sharing Plan
Managed Care & Payer Relationships
- Support payer contract administration, network participation, reimbursement analysis, and implementation of new insurance products and contract changes.
- Research payer policies, insurance products, reimbursement methodologies, and regulatory changes to identify financial and operational impacts.
- Monitor Medicare and applicable federal and state payer requirements, including Virginia-specific regulations.
- Analyze reimbursement rates, fee schedules, and contract provisions to support payer negotiations and organizational decision-making.
- Coordinate with insurance payers, external billing partners, and internal departments to resolve complex reimbursement and contract-related issues.
- Maintain accurate fee schedules and communicate payer updates to ensure consistent implementation across systems and workflows.
- Analyze payment trends and reimbursement patterns to identify underpayments, contract discrepancies, payer configuration issues, and potential revenue leakage.
- Investigate complex payer and reimbursement issues, determine financial impact, and help develop corrective solutions.
- Validate reimbursement accuracy following payer or system corrections.
- Use Excel and other analytical tools to evaluate contract performance, reconcile reimbursement data, and support financial decision-making.
- Serve as a resource to internal teams, including Hospitality, Pre-Authorization, and Operations, on payer participation, insurance coverage, and reimbursement questions.
- Collaborate with external billing partners and affiliated organizations, including Inova Managed Care, to research and resolve payer-related concerns.
- Support payer directory accuracy, network participation, insurance information, and provider or location discrepancies.
- Assist with special billing arrangements, reimbursement evaluations, self-pay pricing, and implementation of new services and rates.
- Support accurate configuration of payer profiles, insurance products, fee schedules, and reimbursement information within revenue cycle systems.
- Participate in system testing and implementation of payer, contract, and workflow changes.
- Identify opportunities to streamline processes, improve reporting, and strengthen reimbursement accuracy.
- Contribute to cross-functional initiatives and special projects supporting revenue cycle performance.
What You'll Bring
Required Qualifications
- Associate degree or higher in Healthcare Administration, Health Sciences, Accounting, or a related field, along with at least one year of healthcare revenue cycle experience in medical billing, payer reimbursement, insurance denials, accounts receivable, or managed care operations. An equivalent combination of education and experience will be considered.
- Working knowledge of healthcare insurance plans, payer requirements, reimbursement methodologies, and medical billing processes.
- Familiarity with CPT/HCPCS and ICD-10 coding concepts.
- Proficiency with Microsoft Excel, including PivotTables, VLOOKUP, and the ability to analyze, reconcile, and interpret reimbursement and financial data.
- Experience researching and resolving complex insurance payer issues, reimbursement discrepancies, or contract-related matters.
- Strong analytical, problem-solving, organizational, and communication skills, with the ability to collaborate effectively with internal and external partners.
- Professional certification in healthcare billing, coding, reimbursement, or revenue cycle, such as CPC, CRCR, CBCS, CRCS, or a comparable certification.
- Experience in managed care, payer contracting, or reimbursement analysis, including experience working with smaller insurance carriers and workers' compensation payers.
Why Fairfax Radiology Centers?
As the largest radiology practice in the Washington, DC metropolitan area, Fairfax Radiology Centers is recognized for combining advanced diagnostic imaging technology with exceptional, patient-centered care.
With more than 20 outpatient imaging centers and a team of subspecialized radiologists, we are committed to delivering high-quality imaging services while continually improving the experience for our patients, referring providers, and employees.
Our culture is built on Respect, Trust, Compassion, and Innovation — values that guide how we care for patients and work together as a team.
Whether your role is clinical, operational, or administrative, your contributions matter.
Ready to Make a Difference?
If you're a healthcare revenue cycle professional who enjoys analyzing data, navigating payer complexities, and finding solutions that improve organizational performance, we'd love to learn more about you.
Join Fairfax Radiology Centers and help support the financial operations that make exceptional patient care possible.
Apply today!
Compensation
Based on your qualifications and experience, the compensation range for this position is:
$58,344 - $78,396 annual salary
Placement within the range is determined by factors including experience, education, certifications, and internal equity.
Equal Opportunity Employer
FRC is committed to diversity, equity, and inclusion. We provide equal employment opportunities to all employees and applicants regardless of race, color, age, religion, sex (including pregnancy), sexual orientation, gender identity or expression, national origin, disability, veteran status, genetic information, or any other protected characteristic.
Apply for this position
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