UT Southwestern Medical Center
Eligibility Denial Specialist I
UT Southwestern Medical Center, Dallas, Texas, United States, 75215
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 Department of Revenue Cycle at UT Southwestern Medical Center has a new employment opportunity available for the role of Eligibility Denial Specialist I MSP. This position is responsible for researching basic denied claims based on eligibility to ensure correct payers are billed timely on submitted insurance claims. The duties for this position will consist of, but are not limited to, the following:
Verifying insurance
Updating registration
Working high volume denial inventory
One on one training along with detailed tip sheets
Parkland Charity knowledge helpful
SHIFT AND LOCATION Shift: Flex‑shift from 0600‑5:00pm, 8‑hours per day. Work From Home (WFH): This is a work from home position. Applicants must live within the state of Texas. Additional details related to this will be discussed as part of the interview process.
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
EXPERIENCE AND EDUCATION Required.
Education:
High School Diploma or equivalent.
Experience:
2 years of medical billing, claims processing, and/or insurance eligibility. May consider medical billing certifications or graduate degrees in lieu of experience.
JOB DUTIES
Review, research and resolve basic denied insurance claims based on eligibility through the billing system, including Medicaid, Medicare, Worker's Compensation, Mental Health payers and third‑party payers.
Interpret Explanation of Benefits from insurance companies on denied claims.
Contact payers via website, phone and/or correspondence regarding claims denied for eligibility.
Contact patients and assist with Coordination of Benefits or other coverage denials.
Work in up to two professional billing service areas.
Update registration and demographic information in at least two hospital billing service areas.
Review and resolve any Visit Filing order changes.
Function as a liaison between clinical departments and third‑party payers.
Complete special projects as requested.
Identify problems and inconsistencies by using management reports; summarize findings and make recommendations to resolve billing issues in an effort to maximize collections.
Duties performed may include one or more of the following core functions: (a) Directly interacting with or caring for patients; (b) Directly interacting with or caring for human‑subject research participants; (c) Regularly maintaining, modifying, releasing or similarly affecting patient records (including patient financial records); or (d) Regularly maintaining, modifying, releasing or similarly affecting human‑subject research records.
Perform other duties as assigned.
SECURITY AND EEO STATEMENT Security This position is security‑sensitive and subject to Texas Education Code 51.215, which authorizes UT Southwestern to obtain criminal history record information.
EEO UT Southwestern Medical Center is committed to an educational and working environment that provides equal opportunity to all members of the University community. As an equal opportunity employer, UT Southwestern prohibits unlawful discrimination, including discrimination on the basis of race, color, religion, national origin, sex, sexual orientation, gender identity, gender expression, age, disability, genetic information, citizenship status, or veteran status.
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JOB SUMMARY The Department of Revenue Cycle at UT Southwestern Medical Center has a new employment opportunity available for the role of Eligibility Denial Specialist I MSP. This position is responsible for researching basic denied claims based on eligibility to ensure correct payers are billed timely on submitted insurance claims. The duties for this position will consist of, but are not limited to, the following:
Verifying insurance
Updating registration
Working high volume denial inventory
One on one training along with detailed tip sheets
Parkland Charity knowledge helpful
SHIFT AND LOCATION Shift: Flex‑shift from 0600‑5:00pm, 8‑hours per day. Work From Home (WFH): This is a work from home position. Applicants must live within the state of Texas. Additional details related to this will be discussed as part of the interview process.
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
EXPERIENCE AND EDUCATION Required.
Education:
High School Diploma or equivalent.
Experience:
2 years of medical billing, claims processing, and/or insurance eligibility. May consider medical billing certifications or graduate degrees in lieu of experience.
JOB DUTIES
Review, research and resolve basic denied insurance claims based on eligibility through the billing system, including Medicaid, Medicare, Worker's Compensation, Mental Health payers and third‑party payers.
Interpret Explanation of Benefits from insurance companies on denied claims.
Contact payers via website, phone and/or correspondence regarding claims denied for eligibility.
Contact patients and assist with Coordination of Benefits or other coverage denials.
Work in up to two professional billing service areas.
Update registration and demographic information in at least two hospital billing service areas.
Review and resolve any Visit Filing order changes.
Function as a liaison between clinical departments and third‑party payers.
Complete special projects as requested.
Identify problems and inconsistencies by using management reports; summarize findings and make recommendations to resolve billing issues in an effort to maximize collections.
Duties performed may include one or more of the following core functions: (a) Directly interacting with or caring for patients; (b) Directly interacting with or caring for human‑subject research participants; (c) Regularly maintaining, modifying, releasing or similarly affecting patient records (including patient financial records); or (d) Regularly maintaining, modifying, releasing or similarly affecting human‑subject research records.
Perform other duties as assigned.
SECURITY AND EEO STATEMENT Security This position is security‑sensitive and subject to Texas Education Code 51.215, which authorizes UT Southwestern to obtain criminal history record information.
EEO UT Southwestern Medical Center is committed to an educational and working environment that provides equal opportunity to all members of the University community. As an equal opportunity employer, UT Southwestern prohibits unlawful discrimination, including discrimination on the basis of race, color, religion, national origin, sex, sexual orientation, gender identity, gender expression, age, disability, genetic information, citizenship status, or veteran status.
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