Technical Denials Management Specialist III


Job Number: 97216
Category: Insurance/Billing
Location: 5323 Harry Hines Blvd, Dallas, TX
Department: 713008 - MG Rev Cyc-Med Follow-Up
Full/Part Time/PRN: Day Job
Regular/Temporary: Regular
Schedule: Full-time

Experience and Education

Associates degree and two (2) years experience with medical claims recovery and/or collections within a healthcare or insurance environment is preferred or High School diploma four (4) years experience with medical claims recovery and/or collections rules and regulations is required.

Job Duties

*Contact 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.

**Other Duties: Performs other duties as assigned.


This position is security-sensitive and subject to Texas Education Code 51.215, which authorizes UT Southwestern to obtain criminal history record information


Salary Negotiable

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.