UT Southwestern Medical Center · 18 hours ago
Technical Denials Management Specialist III
Dallas, TX
Full-time
Hybrid
Mid Level
4+ years expUT Southwestern Medical Center is seeking a Technical Denials Management Specialist III within their Revenue Cycle Department. The role involves reviewing claims, contacting insurance carriers, and resolving denials to maximize collections.
Clinical TrialsHealth CareHospitalMedicalNon ProfitOncologyOutpatient Care
Responsibilities
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
Qualification
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
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, flexibility and analytical skills when resolving more complex unpaid claims
Work requires knowledge of billing and/or collections and regulations
Work requires one to exhibit excellent work ethics and commitment to job responsibilities
Work requires one to possess a professional and courteous demeanor while being assertive and confident in their collection efforts
Work requires one to possess quick and accurate alpha/numeric data entry skills
Work requires presence of a positive image that reflects well on the organization
Work requires strong written and verbal communication skills
Work requires understanding of the requirements of Medicaid, Medicare and insurance billing
Preferred
Work requires knowledge of CMS 1500, ICD-9, and CPT coding
Company
UT Southwestern Medical Center
UT Southwestern Medical Center offers clinical care, education, and scientific research.
10001+ employees
H1B Sponsorship
UT Southwestern Medical Center has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (358)
2024 (238)
2023 (266)
2022 (274)
2021 (213)
2020 (179)
Funding
Current Stage
Late StageTotal Funding
$22MKey Investors
The Dallas FoundationPatient-Centered Outcomes Research Institute
2023-06-20Grant
2023-04-20Grant· $4M
2023-03-28Grant· $18M
Leadership Team
Chris Rubio
Interim Chief Executive Officer, Clements University Hospital
Dennis Pfeifer
AVP & CTO University Health System
Recent News
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