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Technical Denials Management Specialist III
UT Southwestern Medical CenterUnited Statesfull_timeVerifiedPosted 3 Jul 2026
About the role
Technical Denials Management Specialist III - (260000DU)
Description
THE UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER
JOB INFORMATION
Job Code: 7006
Job Title: TECHNL DENIALS MGMT SPEC III
Date Last Edited: 8/22/2025
FLSA Status: N
Job Title: TECHNL DENIALS MGMT SPEC III
Date Last Edited: 8/22/2025
FLSA Status: N
JOB SUMMARY
UT Southwestern Medical Center has an opening within the Revenue Cycle Department team for a Technical Denials Management Specialist III. 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 in an effort to maximize collections. This position is an excellent opportunity for professionals with a background in medical claims, appeals, and payer communications.
UT Southwestern Medical Center has an opening within the Revenue Cycle Department team for a Technical Denials Management Specialist III. 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 in an effort to maximize collections. This position is an excellent opportunity for professionals with a background in medical claims, appeals, and payer communications.
Thid ideal candidate will demonstrate expertise in analyzing the following -
- Explanation of Benefits (EOBs)
- Resolving claim denials
- Managing appeals
- Ensuring time reimbursement
This is a work-from-home (role); however, the selected candidate must reside in the Greater DFW area and be available for occasional onsite visits for training, equipment pickup, and meetings.
Shift: 8-hour days, Monday through Friday
ESSENTIAL FUNCTIONS
Job Duties
- Contact 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.
- Interpret Manage Care contracts and/or Medicare and Medicaid rules and regulations to ensure proper reimbursement/collection.
- Make necessary adjustments as required by plan reimbursement.
- Perform payment validation by utilizing internal and/or external resources to ensure proper reimbursement.
- Review, research and appeal partially denied claims for reconsideration.
- Responsible for contacting patients to gain additional information required to resolve outstanding insurance balances.
- Function as resource person for departmental personnel to answer questions and assist with problem resolution.
- Review and resolve provider NPI/TPI claim edits rejections.
- Review and resolve provider NPI/TPI claim denial.
- Assist with working Claim Edit Work queues.
- Assist with working Team Lead Work queues.
- Assist with New Hire Training.
- Performs other duties as assigned.
QUALIFICATIONS
Education and Experience
Required
- Education
High School Diploma or
Associate's Degree
- Experience
4 years experience in medical claims recovery and/or collections with High School Diploma. or
2 years experience in medical claims recovery and/or collections within a healthcare or insurance environment is preferred with Associates Degree.
Knowledge, Skills and Abilities
- Work requires a self-starter, with ability to work well as part of a team and independently.
- Work requires ability to communicate effectively with patients, insurance companies, clinical staff and management.
- Work requires ability to handle large volumes of work.
- Work requires ability to work in a fast paced, production-oriented environment.
- Work requires excellent customer service skills.
- Work requires experience in Medical Billing, Accounts Receivables, and/or Collections within a healthcare or insurance environment.
- Work requires good organizational,
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