Technical Denials Management Specialist II at UT Southwestern Medical Center in Dallas, Texas

Job Description:

Job Summary:

UT Southwestern Medical Center is the pre-eminent hospital system in Texas and one of the leading facilities nationally, is pleased to announce a new opening for a Technical Denials Management Specialist II within the Revenue Cycle Department team.

This position offers you the opportunity to work from home (WFH) after all training has been completed. Once completed you will need to be available to come into the office for additonal training, meetings etc., as needed.

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. 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.