Technical Denials Management Specialist II - Revenue Cycle

University of Texas Southwestern Medical Center
parental leave, paid time off, paid holidays, tuition reimbursement, remote work
United States, Texas, Dallas
5323 Harry Hines Boulevard (Show on map)
Nov 23, 2024
WHY UT SOUTHWESTERN?With over 75 years of excellence in Dallas-Fort Worth, Texas, UT Southwestern is committed to excellence, innovation, teamwork, and compassion. As a world-renowned medical and research center, we strive to provide the best possible care, resources, and benefits for our valued employees. Ranked as the number 1 hospital in Dallas-Fort Worth according to U.S. News & World Report, we invest in you with opportunities for career growth and development to align with your future goals. Our highly competitive benefits package offers healthcare, PTO and paid holidays, on-site childcare, wage, merit increases and so much more. We invite you to be a part of the UT Southwestern team where you'll discover a culture of teamwork, professionalism, and a rewarding career! JOB SUMMARY: UT Southwestern Medical Center has an opening within the Revenue Cycle Department team for a Technical Denials Management Specialist II. The ideal applicants' day will include but is not limited to the following: Knowledgeable with payors including Managed Care, Commercial, Medicare, and Medicaid Prepare appeals related to denied services Capable of reviewing explanation of benefits (EOB) from payors to determine how the claims was handled Contact insurance carriers to check on the status of claims, appeals, mailing, registration, and insurance verification Other duties as assigned This is a work from home (WFH) opportunity, however, the successful applicant must live within the Greater DFW area and also be available to come to the office for equipment pickup exchange, office meetings, and training, etc. Specific details in regard to WFH shall be discussed as part of the interview process. Shift: 8 hour days, Monday through Friday BENEFITS UT Southwestern is proud to offer a competitive and comprehensive benefits package to eligible employees. Our benefits are designed to support your overall wellbeing, and include: 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 Learn more about these and other UTSW employee benefits! EXPERIENCE/EDUCATION: REQUIRED: Education High School Diploma; Associate's degree preferred Experience Two(2)years experience in medical claims recovery and/or collections required JOB DUTIES: Contacting payers, via website, phone and/or correspondence, regarding reimbursement of unpaid accounts over thirty (30) days or more, also researching and following up on denials and requests for additional information. Interpret Managed Care contracts and/or Medicare and Medicaid rules and regulations to ensure proper reimbursement/collection. Make necessary adjustments as required by plan reimbursement. Performs payment validation by utilizing internal and/or external resources to ensure proper reimbursement. Reviews, research and appeal partially denied claims for reconsideration. Responsible for contacting patients to gain additional information required to resolve an outstanding insurance balance. Functions as resource person for departmental personnel to answer questions and assists with problem resolution. Performs other duties as assigned. SECURITY: This position is security-sensitive and subject to Texas Education Code 51.215, which authorizes UT Southwestern to obtain criminal history record information UT Southwestern Medical Center is committed to an educational and working environment that provides equal opportunity to all members of the University community. As an equal opportunity employer, UT Southwestern prohibits unlawful discrimination, including discrimination on the basis of race, color, religion, national origin, sex, sexual orientation, gender identity, gender expression, age, disability, genetic information, citizenship status, or veteran status. Benefits UT Southwestern is proud to offer a competitive and comprehensive benefits package to eligible employees. Our benefits are designed to support your overall wellbeing, and include: 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 Learn more about these and other UTSW employee benefits!