Technical Denials Management Specialist II - Revenue Cycle

JOB SUMMARY:

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.

UT Southwestern Medical Center has an opening within the Revenue Cycle Department team for a Technical Denial Management Specialist II.

• Shift: 8-hour Days, Monday through Friday
• Work From Home (WFH): This is a work from home opportunity. Candidate must live within the Greater DFW area. Additional details shall be discussed during the interview process.

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.

Quick tip(s):

• Please review the section entitled experience/education and focus on the job requirements.
• Make sure you include the experience listed under the requirements section on your application.

EXPERIENCE/EDUCATION:

REQUIRED:

• High School Diploma Associate's degree preferred
• 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.