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Patient Financial Services Rep. I

Job Number: 69681
Categories: Insurance/Billing
Location: 5323 Harry Hines Blvd, Dallas, TX
Department: 844110 - Patient Financial Services
Full/Part Time/PRN: Day Job
Regular/Temporary: Regular


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


Salary Negotiable

Experience and Education

Minimum 2 years hospitalor medical billing experience.
High School Diploma. Bachelors preferred.
Knowledge of health insurance mechanisms and coverage is required. Effectiveoral and written communications skills. Proficient keyboarding, accuracy and mathaptitude skills.

Job Duties

  • Ensure all claims arebilled and received by the payers for proper adjudication. This includes timelyprocessing of allocated volume of accounts, based on established productionguidelines and time parameters provided for workflow.
  • Responsible for outboundcalls and/or status inquiries via payer’s website validatingreceipt of medical claims and adjudication status within establishedtimeframes. Display competent ability to access, navigate, and manage accountinformation through phone calls and payer websites.
  • Work any edits anddenials in allocated workflow to achieve proper adjudication to payment. Thisincludes, but is not limited to: verify insurance is correct, update insurancedemographics, rebill claims not received, document the status of workperformed, follow-up on outstanding adjudication items according todepartmental guidelines, and is also responsible for billing secondary/tertiaryclaims along with providing supporting documentation to payers for additionalpayment.
  • Documents all work andcalls performed, in accordance to policy. This includes complete contactinformation, good grammar, and expected outcomes.
  • Obtain primary and/orsecondary EOB and claims to bill next responsible payer, along with utilizingvarious internal resources to obtain medical records to respond to requestsfrom payers upon request.
  • 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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