Technical Denials Management Specialist II – Revenue Cycle

JOB SUMMARY:

The Revenue Cycle Department has a new position available for a Technical Denials Management Specialist II. The ideal candidate will have a background as follows: 

• Knowledgeable with payors including Commercial, Medicare/Medicaid and WC
• Ability to form an appeal related to denied services
• Capable of communicating EOG, vouchers., from payors
• Contact insurance carriers to check on status of claims, appears, mailings, registration, insurance verification, etc. 
• Ability to work in a fast-paced environment
• Must be able to learn quickly
• Assist with the creation of new processes
• High volume of accounts responsibility
• Metric requirements 

This will be a work from home position. Exact details related to this shall be discussed during 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:

• High School Diploma or GED
• 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. 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.