Revenue Cycle Transplant Specialist

JOB SUMMARY:
The UT Southwestern Medical Center has an opportunity available for a Transplant Specialist within the Revenue Cycle Department. The primary duties for this position will include but not be limited to the following:
Work paper transplant claims 50% of workload
Claims experience is preferred
Management of transplant patients cases with EPIC
Transplant access database and allocation reporting
Ensure proper billing and payment under contracts
Review charges in EPIC charge review wq's to ensure billing on correct guarantor account type
Process patient referrals/updates within EPIC
Process case rate allocations for distribution across physicians' charges
Auditing of claims processing/payments
Responding to billing/follow-up inquiries when payment issues arise
Shift: Monday through Friday 8am-5pm (flex shift)
This is a work from home position, roughly 40% with three days in the office due to the paper claims load. Details related to this shall be discussed as part of the interview process
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.
EXPERIENCE | EDUCATION:
REQUIRED:
Bachelor's degree in Business Administration, Hospital Administration, or related field preferred
A minimum of five (5) years’ experience in the health care industry to include at least three (3) years in managed care contracting/provider relations or revenue cycle
May consider additional years of healthcare experience in lieu of education
Transplant program experience preferred
JOB DUTIES:
Manages and maintains transplant patients’ referrals and updates throughout the transplant process via internal Access database and Epic Resolute including insurance coverage and charge review for proper billing.
May include coordination of case rate distributions for patients covered under case rate or global payments.
Conducts payment audits on transplant patient accounts working closely with Revenue Cycle and Revenue Accounting.
Intermediary between Revenue Cycle and Transplant Network.
Performs reporting functions and data analysis as needed.
Performs other duties as assigned.
KNOWLEDGE, SKILLS & ABILITIES:
Work requires the ability to analyze contract and financial data, evaluate and interpret contact language and parameters.
Work requires the ability to establish and maintain effective working relationships with a variety of internal and external constituencies.
Work requires proficiency in Microsoft Suite, CPT Codes, ICD-10, and Medical Terminology.
Work requires knowledge of HIPAA and patient confidentiality regulations.
Work requires strong verbal and written communication skills.
Work requires attention to detail with a high degree of accuracy.
Work requires being effectively able to take initiative, multi-task competing priorities and remain focused/organized in a fast-paced environment with limited supervision.
Work requires having a broad knowledge of the managed health care environment including fee schedules, third party reimbursement, and the regulatory and legislative environment.
WORKING CONDITIONS:
Work is performed primarily in a general office 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. 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.