Clinical Denial Management Specialist III

WHY UT SOUTHWESTERN?
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. 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'll discover a culture of teamwork, professionalism, and a rewarding career! 

JOB SUMMARY

The Revenue Cycle Department at UT Southwestern Medical Center has a new opportunity available for a talented Clinical Denial Management Specialist III. The successful candidate will work under moderate supervision to perform advanced level billing/denial responsibilities. The ideal applicant will have three (3) or more years of Clinical follow-up experience of complex minor and/or major surgical procedures. Preference given to applicants with experience in Surgical Oncology, Surgical Transplant, and Oral & Maxillofacial surgery. Clinical Follow up experience using EPIC is highly preferred. CPC certification is a plus.

• Work from home (WFH): This will be a 100% WFH position. Preference given to candidates who live within fifty (50) miles of the DFW area. WFH details shall be discussed as part of the interview process.
• Shift: 8-hour semi-flex shift, Monday through Friday. The shift details shall be discussed as part of the interview process. 

The duties for this position will include but not limited to the following areas of responsibility:

• Collections – Review and resolve accounts promptly per department guidelines. 
• Following policies and guidelines regarding resolving invoices.
• Review documentation – to review, research coding denials for minor/major surgical procedures and any related to E&M, CPT, Diagnosis, or modifier. 
• Call insurance to obtain status update, to resolve complex denial and regarding reimbursement discrepancies. 
• Create and submit appeals based on payer guidelines, on coding denials. 
• Review accuracy of payment to account, reconcile and make necessary adjustment as per EOB. 
• Resolve the discrepancy between insurance and billing.
• Provide feedback on denial trends to leadership. 
• Perform other duties as assigned by leadership. 

BENEFITS
UT 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:

• 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
• Learn more about these and other UTSW employee benefits! 
  
  EXPERIENCE AND EDUCATION
  Required