JOB SUMMARY:

• The applicant will work from home once all onboarding is completed, which may take up to four weeks. Ongoing expectation is to work in-office one day per month for training. Additional details will be discussed as part of the interview process with the hiring team. 
• Must live in the Greater DFW area
• Shift: 0730am-4:30pm

The ideal candidate for this role will have the following attributes: 

• Work independently with little intervention. 
• Manage a workload of assignments and meet timeframes 
• Experience with EPIC. 
• Awareness of insurance plans. 
• Obtains insurance authorization for scheduled Spine Center surgeries at UT Southwestern University Hospitals, Outpatient Surgery Center procedures, and imaging studies.
• Ability to communicate with provider, patient, and support staff to coordinate insurance authorization matters, including requests for estimates, explanation of benefits, and appeals for approval, verbally and in writing. 

Quick tip(s):

• Please review the section entitled experience/education and focus on the job requirements.
• Make sure you include the experience listed under the requirements section on your application. 

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
• And four (4) years progressively responsible experience in medical insurance, medical billing, or medical reimbursement.
• Certified Professional Coder (CPC), Advanced Records Technician (ART), or Registered Records Administrator (RRA) preferred. 
• Any equivalent combination of related education and/or experience may be considered for the above. 

JOB DUTIES: 

• Performs policy analysis for managed care issues by reviewing contracts, writing clause revisions, making recommendations for reimbursement policy changes, reviewing reports and financial data, and analyzing fee schedules, encounter forms, diagnosis, and procedure codes.
• Ensures contracts reflect appropriate business decisions. 
• Ensures projects related to reimbursement issues are completed on time and changes are implemented appropriately by conducting meetings, organizing activities, reviewing data analyses and reports, and creating reimbursement policies and procedures.
• Documents findings by writing inquiry letters, constructing opinion letters, maintaining contract files, and maintaining files for research documents. 
• 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.