Department: University Hospitals
Full/Part Time/PRN: Full-Time
Experience and Education
2.Acquires and maintains thorough knowledge of federal and state legislative and administrative action affecting physician and professional provider reimbursement; disseminates acquired knowledge to faculty and staff.
3.Serves on Edit Administration Committee to approve and advise edit requests for university.
4.Maintains coding edits for Health System Professional Billing to ensure accuracy and compliance.
5.Directs and manages daily operation of departmental in-patient abstracting if completed within the Professional Billing Operations.
6.Analyzes Health System monthly governmental denial reports; reviews for proper coding, unbundling, concurrent care, modifiers, and compliance to ensure maximum reimbursement.
7.Coordinates dissemination of regulation and other contract changes with AVP of Health System Revenue Cycle and Director of Reimbursement for Health System.
8.Facilitate the handling of all payer audits, such as CERT, RAC, OIG, MAC, Medicaid, etc., Maintain and distribute audit activity reports accordingly. Independently working with outside regulatory parties.
9.Develops, implements, and evaluated policies and processes related to reimbursement methodologies.
10.Assure the correct identification, system loading, and communication of reimbursement methodologies for all government payors into EPIC and all other support systems. Must develop and maintain knowledge of system inputs and requirements.
11.Models proposed and approved changes in reimbursement methodologies to determine financial impact. This requires independent research and command of where to obtain the correct information.
12.Extracting large data sets to pull key information for use by other team members. Supporting business planning and decision support of senior leadership.
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.