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Patient Financial Services Rep II

Job Number: 69682
Categories: Insurance/Billing
Location: 5323 Harry Hines Blvd, Dallas, TX
Department: 844110 - Patient Financial Services
Full/Part Time/PRN: Day Job
Regular/Temporary: Regular

Security

This position issecurity-sensitive and subject to Texas Education Code 51.215, which authorizesUT Southwestern to obtain criminal history record information


Salary

Salary Negotiable
Experience and Education

Minimum 5 years hospitalor medical billing experience.
High School Diploma. Bachelors preferred.
Knowledge of health insurance mechanisms and coverage is required. Effectiveoral and written communications skills (including grammar). Proficientkeyboarding, accuracy and math aptitude skills. Competencies: all payerclasses


Job Duties

  • Analyze payerunderpayments, variances, and denials. Escalate trends, make comprehensivesuggestions, and file professional appeals according to our contractualagreements and UT Southwestern policy. This includes timely processing ofallocated volume of accounts, based on established production guidelines andtime parameters provided for workflow.
  • Responsible for outboundcalls and/or status inquiries via payer's website validating receipt of medicalclaims and adjudication status within established timeframes. Display competentability to access, navigate, and manage account information through phone callsand payer websites. Documents all work and calls performed, in accordance topolicy. This includes complete contact information, good grammar, and expectedoutcomes.
  • Display competency andability to work within client based, research, and UTSW special arrangements.This includes, but is not limited to: calculating the physician and hospitalshare and working with MSP to transfer the physician's share to thatdepartment, working with other departments at UTSW to properly invoice clientsand bill claims for proper adjudication per our agreements.
  • Be knowledgeable on allpayer types and effectively work on special projects for specific initiativesfor account resolution projects. Demonstrate confidence and sound decisionmaking for processing through large volumes of denials, complex accounts, orcontractual reviews, as identified from strategic leadership requirements.
  • Make necessary adjustmentsas required by plan reimbursement.
  • Function as adepartmental liaison for billing and collections support for internal andexternal customers, as required.
  • Other Duties: Performsother duties as assigned.

UTSouthwesternMedical Center is committed to an educational and working environment thatprovides equal opportunity to all members of the University community. Inaccordance with federal and state law, the University prohibits unlawfuldiscrimination, including harassment, on the basis of: race; color; religion;national origin; gender, including sexual harassment; age; disability;citizenship; and veteran status. In addition, it is UTSouthwestern policyto prohibit discrimination on the basis of sexual orientation, gender identity,or gender expression.

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2014 Beacon of Excellence Award for Patient Satisfaction – Press Ganey