Account Adjuster II - Revenue Cycle

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 patients and employees. With over 20,000 employees, we are committed to continuing our growth with the best professionals in the healthcare industry. We invite you to be a part of the UT Southwestern team where you'll discover teamwork, professionalism, and consistent opportunities for growth.

VETERANS:

We are honored to be a veteran friendly work environment that is home to hundreds of veterans. We value your integrity, dedication, and the commitment you have made to our country. We are proud to support your next mission. Ranked by Forbes as one of the Top 10 National Employers, we invite you to be a part of the UT Southwestern Medical Center team where you will discover teamwork, professionalism, and consistent opportunities for growth. Shift: 8-hour days The preferred applicant must live in Texas, DFW area is preferred.

JOB SUMMARY:

• The Cash Management Division of the Revenue Cycle Department team has a new opportunity for an Account Adjuster II. The duties for this position will include but not limited to the following:
• Researches and resolves credit balance accounts resulting from payment posting, charge entry, contractual adjustments, and overpayments.
• Analyzes all payer underpayments, variances and denials.

Shift: 8-hour flex, but definitive self-selected start time

Work From Home (WFH): Applicants will be able to work from home. Applicants must live within the State of Texas, DFW area preferred. Additional details shall be discussed as part of the interview process. Quick Tips: Please review the experience/education section thoroughly to verify that you qualify. Please list all applicable experience on your application to make sure we credit you properly.

EXPERIENCE:

REQUIRED:

• High school diploma
• And three (3) years' experience performing follow-up/collections, payment posting, appeals and managed care contract understanding/interpretation is required.
• At least six months related work experience performing appeals and managed care contract understanding/interpretation is preferred.

JOB DUTIES:

• Reviews patient accounts for incorrect posting which may include: contacting insurance companies, patients and researching insurance payments to identify and correct posting errors; reviewing credit reports and age reports to identify posting problems.
• Validate and issue refunds to patients and third party carriers for overpayment or duplicate payment, according to state regulations and contractual obligations.
• Identifies and resolves credits posted to patient accounts; corrects overpayments or distributing funds according to UT Southwestern policy.
• Identifies and denies any refund request letters that are past the insurance refund deadline.
• Appropriately transfer payments between invoices and/or accounts.
• Communicate, approve, and reject refund requests to payers and third party carriers, via phone call and written correspondence.
• Verifies insurance is correct, update insurance demographics, rebill claims and perform appeals if applicable.
• Duties performed may include one or more of the following core functions: (a) Directly interacting with or caring for patients; (b) Directly interacting with or caring for human-subjects research participants; (c) Regularly maintaining, modifying, releasing or similarly affecting patient records (including patient financial records); or (d) Regularly maintaining, modifying, releasing or similarly affecting human-subjects research records.
• Performs other related duties as required.

KNOWLEDGE, SKILLS, & ABILITIES:

• Work requires the ability to use standard office machines such as adding machines, computers, calculators, etc.
• Work requires strong analytical skills. Work requires strong grammatical, writing, and communication skills.
• Work requires critical thinking to validate and dispute audit findings from payers.
• Work requires the ability to type at least 35 words-per-minute. Extreme accuracy in entering facts or figures and in the operation of office machines.
• Work requires the ability to organize and prioritize work to meet deadlines.
• Work requires skills to communicate well in both oral and written forms.
• Work requires knowledge of basic computer software applications.
• Work requires the ability to perform work of considerable complexity including working independently towards general results, devising new work methods, or meeting new conditions necessitating a high degree of ingenuity, initiative, and judgment.

WORKING CONDITIONS:

Work is performed primarily in an office environment.

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.