Technical Denial Management Specialist III bei UT Southwestern Medical Center

%3Cp%3E%3Cstrong%3EWHY UT SOUTHWESTERN?%3C/strong%3E%3Cbr%3EWith 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 employees. Ranked as the number 1 hospital in Dallas-Fort Worth according to %3Ca target=%22_blank%22 rel=%22noopener noreferrer%22 href=%22https://www.utsouthwestern.edu/newsroom/articles/year-2022/july-us-news-best-hospital.html%22%3EU.S. News %26amp; World Report%3C/a%3E, we invest in you with opportunities for career growth and development to align with your future goals. Our highly competitive benefits package offers healthcare, PTO and paid holidays, on-site childcare, wage, merit increases and so much more. We invite you to be a part of the UT Southwestern team where you%27ll discover a culture of teamwork, professionalism, and a rewarding career!%26nbsp;%3Cbr%3E%3Cbr%3E%3Cstrong%3EJOB SUMMARY%3C/strong%3E%3Cbr%3EThe Revenue Cycle Department has a new position available for Technical Denials Management Specialist III.%26nbsp; You will be responsible for billing applicable payers and ensuring timely collections of various insurance claims; will review, research, and appeal complex denials and inadequate payments from third-party payers while identifying trends of payment problems to maximize collections. The successful candidates’ duties will include but not be limited to the following:%3Co:p%3E%3C/o:p%3E%3C/p%3E%3Cul style=%22margin-top:0in;%22 type=%22disc%22%3E%3Cli class=%22MsoNormal%22 style=%22mso-list:l0 level1 lfo1;tab-stops:list .5in;%22%3EProficient in working with various payors, including Managed Care, Commercial, Medicare, and Medicaid.%3Co:p%3E%3C/o:p%3E%3C/li%3E%3Cli class=%22MsoNormal%22 style=%22mso-list:l0 level1 lfo1;tab-stops:list .5in;%22%3EExperienced in managing collections by resolving denials and preparing and submitting appeals for denied services.%3Co:p%3E%3C/o:p%3E%3C/li%3E%3Cli class=%22MsoNormal%22 style=%22mso-list:l0 level1 lfo1;tab-stops:list .5in;%22%3ESkilled in reviewing Explanation of Benefits (EOB) documents from payors to analyze claim processing outcomes.%3Co:p%3E%3C/o:p%3E%3C/li%3E%3Cli class=%22MsoNormal%22 style=%22mso-list:l0 level1 lfo1;tab-stops:list .5in;%22%3EContact insurance carriers to check on the status of claims, appeals, mailing, registration, and insurance verification.%3Co:p%3E%3C/o:p%3E%3C/li%3E%3C/ul%3E%3Cp class=%22MsoNormal%22%3EShift: Flex, start between 0600-0900, Monday through Friday%3Co:p%3E%3C/o:p%3E%3C/p%3E%3Cp class=%22MsoNormal%22%3EWork From Home (WFH): This is a WFH position, however, the successful applicant must live within the Greater DFW area and be available to come to the office for equipment pickup/exchange, office meetings, training, etcetera. Additional details related to WFH shall be discussed as part of the interview process.%26nbsp;%3Co:p%3E%3C/o:p%3E%3C/p%3E%3Cp%3E%3Cstrong%3EBENEFITS%3C/strong%3E%3Cbr%3EUT Southwestern is proud to offer a competitive and comprehensive benefits package to eligible employees. Our benefits are designed to support your overall wellbeing, and include:%3C/p%3E%3Cul%3E%3Cli%3EPPO medical plan, available day one at no cost for full-time employee-only coverage%3C/li%3E%3Cli%3E100% coverage for preventive healthcare-no copay%3C/li%3E%3Cli%3EPaid Time Off, available day one%3C/li%3E%3Cli%3ERetirement Programs through the Teacher Retirement System of Texas (TRS)%3C/li%3E%3Cli%3EPaid Parental Leave Benefit%3C/li%3E%3Cli%3EWellness programs%3C/li%3E%3Cli%3ETuition Reimbursement%3C/li%3E%3Cli%3EPublic Service Loan Forgiveness (PSLF) Qualified Employer%3C/li%3E%3Cli%3E%3Ca target=%22_blank%22 rel=%22noopener noreferrer%22 href=%22http://jobs.utsouthwestern.edu/benefits/#top%22%3ELearn more about these and other UTSW employee benefits!%3C/a%3E%3Cbr%3E%3Cbr%3E%3Cstrong%3EEXPERIENCE AND EDUCATION%3C/strong%3E%3Cbr%3E%3Cbr%3E%3Cstrong%3ERequired%3C/strong%3E%3C/li%3E%3Cli%3E%3Cstrong%3EEducation%3C/strong%3E%3Cbr%3EHigh School Diploma or%26nbsp;%3Cbr%3EAssociate%27s Degree%26nbsp;%3Cbr%3E%26nbsp;%3C/li%3E%3C/ul%3E%3Cul%3E%3Cli%3E%3Cstrong%3EExperience%3C/strong%3E%3Cbr%3E4 years experience in medical claims recovery and/or collections with High School Diploma. or%26nbsp;%3Cbr%3E2 years experience in medical claims recovery and/or collections within a healthcare or insurance environment is preferred with Associates Degree.%26nbsp;%3C/li%3E%3C/ul%3E%3Cp%3E%3Cstrong%3EJOB DUTIES%3C/strong%3E%3C/p%3E%3Cul%3E%3Cli%3EContact 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 request for additional information.%3C/li%3E%3Cli%3EInterpret Manage Care contracts and/or Medicare and Medicaid rules and regulations to ensure proper reimbursement/collection.%3C/li%3E%3Cli%3EMake necessary adjustments as required by plan reimbursement.%3C/li%3E%3Cli%3EPerform payment validation by utilizing internal and/or external resources to ensure proper reimbursement.%3C/li%3E%3Cli%3EReview, research and appeal partially denied claims for reconsideration.%3C/li%3E%3Cli%3EResponsible for contacting patients to gain additional information required to resolve outstanding insurance balances.%3C/li%3E%3Cli%3EFunction as resource person for departmental personnel to answer questions and assist with problem resolution.%3C/li%3E%3Cli%3EReview and resolve provider NPI/TPI claim edits rejections.%3C/li%3E%3Cli%3EReview and resolve provider NPI/TPI claim denial.%3C/li%3E%3Cli%3EAssist with working Claim Edit Work queues.%3C/li%3E%3Cli%3EAssist with working Team Lead Work queues.%3C/li%3E%3Cli%3EAssist with New Hire Training.%3C/li%3E%3Cli%3EPerforms other duties as assigned.%3C/li%3E%3C/ul%3E%3Cp%3E%3Cstrong%3ESECURITY AND EEO STATEMENT%3C/strong%3E%3Cbr%3E%3Cbr%3E%3Cstrong%3ESecurity%3C/strong%3E%3Cbr%3EThis position is security-sensitive and subject to Texas Education Code 51.215, which authorizes UT Southwestern to obtain criminal history record information.%3Cbr%3E%3Cbr%3E%3Cstrong%3EEEO%3C/strong%3E%3Cbr%3EUT 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.%3Cbr%3E%26nbsp;%3C/p%3E Jetzt bewerben