Homeoffice Manager, Clinical Denials at UT Southwestern Medical Center

%3Cp style=%22font-family: Arial;%22%3E%3Cb%3EWHY UT SOUTHWESTERN?%3C/b%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 href=%22https://www.utsouthwestern.edu/newsroom/articles/year-2022/july-us-news-best-hospital.html%22 target=%22_blank%22 rel=%22noopener%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! %3Cbr%3E%3Cbr%3E%3Cb%3EJOB SUMMARY%3C/b%3E%3C/p%3E%0A%3Cp class=%22MsoNormal%22 style=%22margin: 0px 0px 9pt; color: rgb(0, 0, 0); font-family: %27Open Sans%27, %27Segoe UI%27, Frutiger, %27Frutiger Linotype%27, %27Dejavu Sans%27, %27Helvetica Neue%27, Arial, sans-serif; font-size: 13.02px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; line-height: normal; background: white;%22%3E%3Cspan style=%22font-size: 12px;%22%3E%3Cspan style=%22font-family: arial, helvetica, sans-serif;%22%3E%3Cspan style=%22color: black;%22%3EUT Southwestern has an amazing leadership opportunity available in the Revenue Cycle Department team. The successful applicant%27s duties will include but is not limited to the following:%26nbsp;%3Co:p%3E%3C/o:p%3E%3C/span%3E%3C/span%3E%3C/span%3E%3C/p%3E%0A%3Cul type=%22disc%22 style=%22margin: 12px 0px; padding: 0px 0px 0px 20px; color: rgb(0, 0, 0); font-family: %27Open Sans%27, %27Segoe UI%27, Frutiger, %27Frutiger Linotype%27, %27Dejavu Sans%27, %27Helvetica Neue%27, Arial, sans-serif; font-size: 13.02px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: rgb(255, 255, 255); text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;%22%3E%0A%3Cli class=%22MsoNormal%22 style=%22line-height: normal; color: black; background: white;%22%3E%3Cspan style=%22font-size: 12px;%22%3E%3Cspan style=%22font-family: arial, helvetica, sans-serif;%22%3EManage two (2) supervisors and a team of clinical denials specialists.%26nbsp;%3Co:p%3E%3C/o:p%3E%3C/span%3E%3C/span%3E%3C/li%3E%0A%3Cli class=%22MsoNormal%22 style=%22line-height: normal; color: black; background: white;%22%3E%3Cspan style=%22font-size: 12px;%22%3E%3Cspan style=%22font-family: arial, helvetica, sans-serif;%22%3EResponsible for the management of clinical denials, across all payors Will work to assure optimal reimbursement for professional services rendered by UTSW providers.%3Co:p%3E%3C/o:p%3E%3C/span%3E%3C/span%3E%3C/li%3E%0A%3Cli class=%22MsoNormal%22 style=%22line-height: normal; color: black; background: white;%22%3E%3Cspan style=%22font-size: 12px;%22%3E%3Cspan style=%22font-family: arial, helvetica, sans-serif;%22%3EMust know EPIC.%26nbsp;%3Co:p%3E%3C/o:p%3E%3C/span%3E%3C/span%3E%3C/li%3E%0A%3Cli class=%22MsoNormal%22 style=%22line-height: normal; color: black; background: white;%22%3E%3Cspan style=%22font-size: 12px;%22%3E%3Cspan style=%22font-family: arial, helvetica, sans-serif;%22%3EMust be a critical thinker and analytical person.%26nbsp;%3Co:p%3E%3C/o:p%3E%3C/span%3E%3C/span%3E%3C/li%3E%0A%3Cli class=%22MsoNormal%22 style=%22line-height: normal; color: black; background: white;%22%3E%3Cspan style=%22font-size: 12px;%22%3E%3Cspan style=%22font-family: arial, helvetica, sans-serif;%22%3EAbility to lead/manage a team.%26nbsp;%3Co:p%3E%3C/o:p%3E%3C/span%3E%3C/span%3E%3C/li%3E%0A%3C/ul%3E%0A%3Cp class=%22MsoNormal%22 style=%22margin: 0px 0px 12px 0.25in; color: rgb(0, 0, 0); font-family: %27Open Sans%27, %27Segoe UI%27, Frutiger, %27Frutiger Linotype%27, %27Dejavu Sans%27, %27Helvetica Neue%27, Arial, sans-serif; font-size: 13.02px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; line-height: normal; background: white;%22%3E%3Cspan style=%22font-size: 12px;%22%3E%3Cspan style=%22font-family: arial, helvetica, sans-serif;%22%3E%3Cspan style=%22color: black;%22%3EWork From Home (WFH): This is 100% work from home position. DFW metroplex candidates strongly preferred. Unable to consider those residing outside of the state of Texas. Additional details regarding WFH will be discussed during the interview.%3Co:p%3E%3C/o:p%3E%3C/span%3E%3C/span%3E%3C/span%3E%3C/p%3E%0A%3Cp class=%22MsoNormal%22 style=%22margin: 0px 0px 12px 0.25in; color: rgb(0, 0, 0); font-family: %27Open Sans%27, %27Segoe UI%27, Frutiger, %27Frutiger Linotype%27, %27Dejavu Sans%27, %27Helvetica Neue%27, Arial, sans-serif; font-size: 13.02px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; line-height: normal; background: white;%22%3E%3Cspan style=%22font-size: 10pt; font-family: Arial, sans-serif; color: black;%22%3E%3Cspan style=%22font-size: 12px;%22%3E%3Cspan style=%22font-family: arial, helvetica, sans-serif;%22%3EShift: 8-hour days, Monday through Friday%3C/span%3E%3C/span%3E%3C/span%3E%3C/p%3E%0A%3Cp style=%22font-family: Arial;%22%3E%3Cb%3EBENEFITS%3C/b%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%0A%3Cul%3E%0A%3Cli%3EPPO medical plan, available day one at no cost for full-time employee-only coverage%3C/li%3E%0A%3Cli%3E100% coverage for preventive healthcare-no copay%3C/li%3E%0A%3Cli%3EPaid Time Off, available day one%3C/li%3E%0A%3Cli%3ERetirement Programs through the Teacher Retirement System of Texas (TRS)%3C/li%3E%0A%3Cli%3EPaid Parental Leave Benefit%3C/li%3E%0A%3Cli%3EWellness programs%3C/li%3E%0A%3Cli%3ETuition Reimbursement%3C/li%3E%0A%3Cli%3EPublic Service Loan Forgiveness (PSLF) Qualified Employer%3C/li%3E%0A%3Cli%3E%3Ca href=%22http://jobs.utsouthwestern.edu/benefits/#top%22 target=%22_blank%22 rel=%22noopener%22%3ELearn more about these and other UTSW employee benefits!%3C/a%3E%3C/li%3E%0A%3C/ul%3E%0A%3Cp style=%22font-family: Arial;%22%3E%3Cb%3E%3Cb%3EEXPERIENCE AND EDUCATION%3C/b%3E%3C/b%3E%3Cbr%3E%3Cb%3ERequired%3C/b%3E%3Cb%3E%3C/b%3E%3C/p%3E%0A%3Cul%3E%0A%3Cli%3E%3Cb%3EEducation%3C/b%3E%3Cbr%3EHigh School Diploma Or equivalent%26nbsp;%3C/li%3E%0A%3C/ul%3E%0A%3Cp style=%22font-family: Arial;%22%3E%3Cb%3E%3C/b%3E%3C/p%3E%0A%3Cul%3E%0A%3Cli%3E%3Cb%3EExperience%3C/b%3E%3Cbr%3E7 years of professional revenue cycle working experience; including %3Cbr%3E4 years of medicine, ancillary, or surgical coding %3Cbr%3E1 year of clinical and or technical denials management/ prevention %3Cbr%3E3 years of progressive management in health care administration, physician group practice, and/or claims processing and %3Cbr%3EManager experience must include producing positive results in a 100% metric driven work environment %3Cbr%3EAdvanced degree(s) (Bachelors, Masters) may be considered in lieu of experience. %3C/li%3E%0A%3C/ul%3E%0A%3Cp style=%22font-family: Arial;%22%3E%3Cb%3EPreferred%3C/b%3E%3Cb%3E%3C/b%3E%3C/p%3E%0A%3Cul%3E%0A%3Cli%3E%3Cb%3EEducation%3C/b%3E%3Cbr%3EBachelor%27s Degree %3C/li%3E%0A%3C/ul%3E%0A%3Cp style=%22font-family: Arial;%22%3E%3Cb%3E%3C/b%3E%3C/p%3E%0A%3Cul%3E%0A%3Cli%3E%3Cb%3ELicenses and Certifications%3C/b%3E%3Cbr%3EProfessional Coding Certification Upon Hire %3C/li%3E%0A%3C/ul%3E%0A%3Cp style=%22font-family: Arial;%22%3E%3Cb%3E%3Cb%3EJOB DUTIES%3C/b%3E%3C/b%3E%3C/p%3E%0A%3Cul%3E%0A%3Cli%3EAccountable and responsible for the clinical denial prevention and management program for either the centralized Medicine and Ancillary or Surgical revenue cycles in a collections metric driven environment. Monitor appeal effectiveness and denial prevention efforts by reviewing Epic work queues and reports, MS Excel remit code level reports, and the Epic staff note payment percentage report. Monitors Epic follow-up work queue automation rules to ensure they are functioning correctly and or if adjustments or new rules need to be written. Conducts analysis of denials and denial trends by type and payor. Monitors payor reimbursement policies to prevent future claim denials and or internal denial routing for correct and prompt resolution.%3C/li%3E%0A%3Cli%3ECoordinates, with supervisor, the appeals process for all balances deemed appropriate. Facilitates payor denials related communication with revenue cycle operations staff, clinical operations staff, and Revenue Cycle Operations management.%3C/li%3E%0A%3Cli%3EWorks with staff to identify the root cause of denials and to implement effective strategies and process improvements, to reduce costly delays in payment. Assures prompt action is taken on denials by coordinating with supervisor/staff to create written and/or verbal clinical appeals with payers.%3C/li%3E%0A%3Cli%3EFormulates letters of appeal. Ensuring they include relevant and effective clinical documentation from the medical record; supported by current industry clinical guidelines, evidence based medicine, local and national medical management standards and clinical protocols.%3C/li%3E%0A%3Cli%3EActively participates in the University Edit Administration Committee to ensure accountability for denials reduction performance, and ensures compliance with all governmental regulations and non-governmental guidelines.%3C/li%3E%0A%3Cli%3EMaintains and applies an excellent understanding of physician reimbursement policy and coding methodologies including, but not limited to AMA, CMS and specialty societies to ensure physician practice revenue integrity and compliant documentation and coding.%3C/li%3E%0A%3Cli%3EPerforms other duties as assigned.%3C/li%3E%0A%3C/ul%3E%0A%3Cp style=%22font-family: Arial;%22%3E%3Cb%3E%3Cb%3ESECURITY AND EEO STATEMENT%3C/b%3E%3C/b%3E%3Cbr%3E%3Cbr%3E%3Cb%3ESecurity%3C/b%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%3Cb%3EEEO Statement%3C/b%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.%3C/p%3E Apply Now