Physicians Billing Authorization Specialist III-MSRDP
Job Number: 374342
Location: 5323 Harry Hines Blvd, Dallas, TX
Department: 713005 - MG Rev Cyc-Surg Follow Up
Full/Part Time/PRN: Day Job
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
Associates degree and four (4) years medical billing experience including insurance verification and obtaining authorizations, knowledge of billing and/or collections rules and regulations; or
High school diploma or equivalent and six (6) years medical billing experience including insurance verification and obtaining authorizations, knowledge of billing and/or collections rules and regulations is required.
- Reviews clinical documentation for CPT/diagnosis code information to support pre-certification according to payor policy. Maintains department productivity standards.
- Identifies and verifies all essential information pertaining to insurance verification/eligibility and pre-certification on complex and specialized patient accounts. Additional research and knowledge is needed to obtain accurate information in a timely manner.
- Counsels offices and/or patents when an out of network situation becomes apparent or other potential payor technicalities arise.
- Provides support to lower level specialists.
- 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); or (d) Regularly maintaining, modifying, releasing or similarly affecting human-subjects research records.
- Performs other duties as assigned.
Knowledge, Skills & Abilities
- Work requires ability to work in a fast paced, production oriented environment.
- Work requires strong knowledge of CPT, HCPCS and ICD-10 coding
- Work requires knowledge of insurance verification and benefits.
- Work requires strong organizational skills
- Work requires good oral and written communication skills, including the use of medical terminology.
- Work requires proficient skills working with spreadsheet and word processing software.
Work is performed primarily in a general office environment.
UTSouthwestern 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; sex; including sexual harassment; age; disability; genetic information; citizenship status; and protected veteran status. In addition, it is UTSouthwestern policy to prohibit discrimination on the basis of sexual orientation, gender identity, or gender expression.