Technical Denials Management Specialist III - Revenue Cycle
Dallas, Texas
Employer: UT Southwestern Medical Center
Industry: Insurance/Billing
Salary: Competitive
Job type: Full-Time
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.
The Revenue Cycle Department team has a new position available for Technical Denials Management Specialist III. The successful candidates' duties will include but not be limited to the following:
Shift: Flex shift, 8-hour days, Monday through Friday
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:
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.
The Revenue Cycle Department team has a new position available for Technical Denials Management Specialist III. The successful candidates' duties will include but not be limited to the following:
- Knowledgeable with payors including Managed Care, Commercial, Medicare, and Medicaid.
- Collections - Resolve denials. Prepare appeals related to denied services.
- Capable of reviewing the Explanation of Benefits (EOB) from payors to determine how the claim was handled.
- Contact insurance carriers to check on the status of claims, appeals, mailing, registration, and insurance verification.
- Customer Service background preferred Will be responsible for taking live calls
Shift: Flex shift, 8-hour days, Monday through Friday
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
- Four (4) years' experience in medical claims recovery and/or collections required.
- Associate degree and two (2) years' experience in medical claims recovery and/or collections within a healthcare or insurance environment is preferred.
- Contact 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.
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.
Created: 2024-09-20
Reference: 812121
Country: United States
State: Texas
City: Dallas
ZIP: 75287
Similar jobs:
-
Emergency Management Specialist (Response)
Federal Emergency Management Agency in Denton, Texas -
Supervisory Building Management Specialist
Public Buildings Service in Laredo, Texas💸 $107401 per year -
LOGISTICS MANAGEMENT SPECIALIST
Air Education and Training Command in Laughlin AFB, Texas -
Local Hire (Emergency Management Specialist 3)
Federal Emergency Management Agency in Austin, Texas -
Supervisory Records Management Specialist
Citizenship and Immigration Services in El Paso, Texas -
LOGISTICS MANAGEMENT SPECIALIST
Defense Counterintelligence and Security Agency in Farmers Branch, Texas -
Supervisory Building Management Specialist
Public Buildings Service in Laredo, Texas💸 $107401 per year -
RESOURCES MANAGEMENT SPECIALIST
Air Force Manpower Analysis Agency in Randolph AFB, Texas -
SUPERVISORY LOGISTICS MANAGEMENT SPECIALIST
Air Force Materiel Command in Lackland AFB, Texas -
TPWD - Program Management Specialist III (Wildlife Landowner Liaison)
CAPPS in Austin, Texas -
MISSION SUPPORT SPECIALIST (WORKFORCE MANAGEMENT)
Customs and Border Protection in El Paso, Texas💸 $86962.00 per year -
Workforce Management Specialist | Monetization Integrity
TikTok in Austin, Texas -
Vessel Traffic Management Specialist, GS-2150-11
U.S. Coast Guard in Port Arthur, Texas -
Emergency Management Specialist (Recovery)
Federal Emergency Management Agency in Denton, Texas -
Industrial Property Management Specialist
Defense Contract Management Agency in Fort Worth, Texas -
Health Information Records Management Specialist - Heart & Vascular Specialists Clinic - Full-Time, Days
Texas Health Resources in Bedford, Texas -
Senior Specialist, Program Management
L-3 Technologies in Greenville, Texas -
Emergency Management Specialist
Houston Journal of Health Law & Policy in Houston, Texas -
Content Management Specialist / Website Content Administrator - REMOTE
System One Holdings, LLC in Dallas, Texas -
Supervisory Correctional Treatment Specialist (Case Management Coordinator)
Justice, Bureau of Prisons/Federal Prison System in Seagoville, Texas💸 $103919 per year