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.
COVID-19 Mandate
Compliance with the COVID-19 vaccine mandate enforced by the Centers for Medicare and Medicaid (CMS) is a requirement for this position. Federal law requires individuals holding this position to be fully vaccinated or have an approved exemption for certain medical, disability, or religious reasons. Individuals who do not meet CMS vaccination requirements are not eligible and should not apply for this position but are encouraged to apply for other non-healthcare positions at UT Southwestern for which they qualify.
For COVID-19 vaccine information, applicants should visit https://www.utsouthwestern.edu/covid-19/work-on-campus/
UT Southwestern has an opening for a Technical Denials Management Specialist II within the Revenue Cycle-Front End Department team.
This is a work from home position. Exact details to be discussed during the interview process with the hiring manger.
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.