Billing Specialist I

JOB SUMMARY:

The UT Southwestern Medical Center Department of Dermatology provides patient care at UT Southwestern , Parkland Memorial Hospital , the Dallas Veterans Affairs Medical Center , and Children's Health℠ Children's Medical Center Dallas . When all patient care responsibilities at these sites are totaled, our Department is responsible for greater than 80,000 ambulatory encounters annually. Subspeciality care is provided in Adult Medical Dermatology, Dermatologic Surgery, Dermatopathology, Pediatric Dermatology, Phototherapy, and Cosmetic Dermatology. strives to foster excellence in health care delivery, education, and research by recognizing the uniqueness in our patients, faculty, trainees, and staff. We represent a diverse team of individuals with different life experiences, skillsets, and viewpoints.

About the department:

The billing team consists of 2-Billing Specialist I, 1-Billing Specialist ll as well as a 1-Reimbursement Specialist. You will crosstrain to learn all aspects of the role. The culture is team based, structured, and striving to provide the best level of care and service to their valued patients.

The ideal candidate for this role duties will include but not limited to the following:

• Utilizing Epic Resolute to review and clear charges for the Dermatology Clinic.
• Requires the ability to read the progress notes and/or procedure results and confirm with Providers to make the necessary changes to the CPT code(s), diagnosis code(s) and modifiers (if applicable).
• Familiar with the Medicare and Medicaid teaching physician documentation billing rules.
• Communicates billing issues with Supervisor.
• This position requires a high degree of organization and accuracy, and requires clear communication with providers on a regular basis to ensure visits are well documented and meet all billing requirements.
• Investigates and resolves coding and registration claim edits for Derm clinic.
• Clears and work denials from assigned Dermatology denial WQ's by utilizing knowledge of Medicare and billing/coding guidelines.
• Versatile and willing to Crosstrain in multiple billing operations.

Shift: 8am-5pm

Hybrid work schedule with the ability to work from home 2-3 days per weeks. Additional details to be discussed as part of the interview process.

EXPERIENCE | EDUCATION:

• High School diploma or equivalent
• And one (1) year medical billing or collections experience.
• Must demonstrate the ability to perform manual charge entry, release clean claim encounters within charge review work queues, investigate and resolve basic coding and registration claim edits and make calls to obtain authorizations.
• Coding certifications (CPC, CPMA, CMC, ART, RRA, RHIA, RHIT, CCS, CCA) and/or degrees (associate level, bachelor level, master level) preferred and may be considered in lieu of experience.

JOB DUTIES:

• Performs manual charge entry for all non-EpicCare and non-automated sites of services. This includes E&M visits and procedures across several centralized service lines. This position requires periodic communication with providers.
• Releases ambulatory and inpatient clean charges from charge review work queues.
• Investigates and resolves basic coding and registration claim edits and credits.
• May assist in obtaining insurance authorizations and accurately maintaining the authorization records, communicate patient balance and patient-responsibility amounts to clinics and/or patient/families, responding to requests for information. Attend coding and billing in-services to stay current on changes; attend other meetings and training as assigned.
• Perform monthly charge reconciliation.
• 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 duties as assigned.

KNOWLEDGE, SKILLS & ABILITIES:

• Work requires working knowledge of Epic Resolute, EpicCare, and Epic CPOE
• Work requires working knowledge of MS Excel.
• Work requires ability to analyze problems, develop solutions, and implement new procedures.
• Work requires ability to prioritize large volumes of work.
• Work requires good communication skills.

WORKING CONDITIONS:

Work is performed primarily in general office/clinic area.

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. In accordance with federal and state law, the University prohibits unlawful discrimination, including harassment, on the basis of: race; color; religion; national origin; sex; including sexual harassment; age; disability; genetic information; citizenship status; and protected veteran status. In addition, it is UT Southwestern policy to prohibit discrimination on the basis of sexual orientation, gender identity, or gender expression.