Claims Edit Specialist I Msrdp - Revenue Cycle

JOB SUMMARY:
The Revenue Cycle Department has a new opportunity available for the role of Claims Edit Specialist I MSRDP.
Work from home: The candidate will work from home and must live within the Greater DFW area. Additional details related to this shall be discussed as part of the interview process.
Shift: Flex that can begin from 6am-9am
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.
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 will discover teamwork, professionalism, and consistent opportunities for growth.
EXPERIENCE | EDUCATION:REQUIRED:
High school diploma or equivalent.
And, two (2) years’ experience with medical billing or claims processing.
Knowledge of billing and/or collections rules and regulations is required.
May consider education in lieu of experience.
JOB DUTIES:
This job is responsible for reviewing and processing basic and complex insurance claim edits in a timely manner under direct supervision of supervisor.
Reviews and processes basic insurance claim edits through the billing system for registration and demographic accuracy.
Utilizes vendor and third-party websites for eligibility/benefit verification, including update of registration information within the billing system.
Reposts and resubmits claims based on research findings and billing system updates.
Works in all professional billing service areas.
Updates registration and demographic information in at least two hospital billing service areas.
Escalates issues above knowledge base to higher level specialist or supervisor.
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 the ability to work in a fast paced, production-oriented environment.
Work requires knowledge of insurance billing and various types of health insurance.
Work requires strong organizational skills.
Work requires good oral and written communication skills, including the use of medical terminology.
Work requires basic working knowledge of spreadsheet and word processing software.
WORKING CONDITIONS:
Work is performed primarily in a general 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. To learn more, please visit: why-work-here/diversity-inclusion