UT Southwestern Medical Center logo
UT Southwestern Medical Center

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 employees. Ranked as the number 1 hospital in Dallas-Fort Worth according to U.S. News & World Report, we invest in you with opportunities for career growth and development to align with your future goals.

Eligibility Denial Specialist I

Claims SpecialistClaims SpecialistFull TimeRemoteMid LevelTeam 5,001-10,000

Location

United States

Posted

4 days ago

Salary

0

Seniority

Mid Level

No structured requirement data.

Job Description

Eligibility Denial Specialist I

UT Southwestern Medical Center

Role Description The Department of Revenue Cycle at UT Southwestern Medical Center has a new employment opportunity available for the role of Eligibility Denial Specialist I MSP. This position is responsible for researching basic denied claims based on eligibility to ensure correct payers are billed timely on submitted insurance claims. The duties for this position will consist of but are not limited to the following: - Maintain regular phone communication with patients and insurance companies - Verifying insurance - Updating registration - Working high volume denial inventory - One on one training along with detailed tip sheets - Experience with Parkland Charity processes is preferred Shift: Flex-shift from 0600-5:00pm, 8-hours per day Work From Home (WFH): This is a work from home position. Applicants must live within the Greater DFW area. Additional details related to this will be discussed as part of the interview process. Qualifications - High School Diploma or equivalent - 2 years of medical billing, claims processing, and/or insurance eligibility - May consider medical billing certifications or graduate degrees in lieu of experience Requirements - Review, research and resolve basic denied insurance claims based on eligibility through the billing system, including Medicaid, Medicare, Worker's Compensation, Mental Health payers and third-party payers - Interpret Explanation of Benefits from insurance companies on denied claims - Contact payers via website, phone and/or correspondence regarding claims denied for eligibility - Contact patients and assist with Coordination of Benefits or other coverage denials - Works in up to two professional billing service areas - Updates registration and demographic information in at least two hospital billing service areas - Review and resolve any Visit Filing order changes - Functions as a liaison between clinical departments and third-party payers - Completes special projects as requested - Identifies problems and inconsistencies by using management reports; summarizes findings and makes recommendations to resolve billing issues in an effort to maximize collections - Duties performed may include one or more of the following core functions: - Directly interacting with or caring for patients - Directly interacting with or caring for human-subjects research participants - Regularly maintaining, modifying, releasing or similarly affecting patient records (including patient financial records) - Regularly maintaining, modifying, releasing or similarly affecting human-subjects research records - Performs other duties as assigned Benefits - PPO medical plan, available day one at no cost for full-time employee-only coverage - 100% coverage for preventive healthcare - no copay - Paid Time Off, available day one - Retirement Programs through the Teacher Retirement System of Texas (TRS) - Paid Parental Leave Benefit - Wellness programs - Tuition Reimbursement - Public Service Loan Forgiveness (PSLF) Qualified Employer

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