Billing Specialist I - Pathology
Categories: Insurance / Billing
Full/Part Time/PRN: Full-Time
This position is security-sensitive and subject to Texas Education Code 51.215, which authorizes UT Southwestern to obtain criminal history record information
Experience and Education
High School diploma or GED and two (2) years medical billing or collections experience required. Certified Professional Coder (CPC),Advanced Records Technician (ART), or Registered Records Administrator (RRA) preferred.
Identifies problems and inconsistencies with federal and state agency, commercial or patient billings utilizing various reports; researches problems, summarizes findings and makes recommendations.
Determines impact of program policy changes and develops action plan to comply with new billing regulations.
Receives, researches and resolves correspondence from insurance carriers or private patients concerning cliams.
Reviews and/or data enters charge forms.
Processes on-line billing interfaces and/or interface edits; identifies and resolves problems as they arise.
Reviews and corrects claim edits and denials to ensure proper payment for services rendered.
Pre-certifies patient care procedures.
Completes special projects that may require defining problems, determining work sequence and summarizing findings.
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); (d) Regularly maintaining, modifying, releasing or similarly affecting human-subjects research records.
Performs other duties as assigned.
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; gender, including sexual harassment; age; disability; citizenship; and veteran status. In addition, it is UT Southwestern policy to prohibit discrimination on the basis of sexual orientation, gender identity, or gender expression.