MSRDP Team Lead - Surgical Billing Follow Up
Categories: Insurance / Billing
Department: MSRDP Team 4 Admin
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
Associate's degree or two years college with credit hours in Business Administration, Health Care Administration, or related field or High school diploma or equivalent and six (6) years progressively responsible experience in medical insurance, medical billing or medical reimbursement.
1. Provides orientation and training for new hires on insurance follow-up work flow processes, system functions, and activities required to perform job.
2. Participates in development and maintenance of departmental work flows to ensure compliance of billing regulations and payer policy changes.
3. Receives, researches, and resolves billing discrepancies from insurance carriers, and MSRDP representatives.
4. Assist in the identification of claim form issues and elevate to supervisor for further research and resolution.
5. Functions as liaison between Provider Relations and MSRDP to resolve provider NPI/TPI external edit conditions.
6. Complete special projects which require defining problems, determining work sequence, summarizing findings and making recommendations.
7. Provides feedback to MSRDP Supervisors regarding training experience along with additional opportunities for continued growth and improvement.
8. Resolves complex claim denials elevated from Medical Collectors II and/or III by contacting insurance companies, places of employment, federal and state agencies, or patients.
Performs other duties as assigned.
This person would be acting as a liaison to the departments of OBGYN, CVTS, and Otolaryngology for the authorization/verification team. Team Leads are responsible training new employees as well as providing additional training to existing staff. The Team Leads are expected to maintain a quality average of 98% accuracy while meeting and/or exceeding the production standard of 60-80 authorization/verifications per day. Team Leads are responsible for the Claim Edit Work queues and DARS that require a higher analytical skill sets. 10 analyst would report up through this team lead position. This position is responsible for the OBGYN, CVTS, and Otolaryngology DAR's and to guide and keep the staff to a minimum of 2 weeks out. The volume has and will continue to increase due to addition of the Moncrief Ft Worth location, and several surgical sites with THR, Plaza, and JPS and as we centralize other departments.
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.