Patient Financial Services Rep II - Traditional Medicare Billing %26 Collections

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%27ll discover a culture of teamwork, professionalism, and a rewarding career! 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! Work Schedule: Flexibility start time from 7am-9am thru 3:30pm-5pm. This is a remote position however; candidate must live in the Dallas Fort Worth metroplex due to occasional onsite meetings/trainings. This will be discussed more in the interview. EXPERIENCE AND EDUCATION Required Education High School Diploma and Experience 5 years hospital or medical billing experience. Preferred Education Bachelor%27s Degree Experience Experienced collector for Traditional Medicare with billing experience and EPIC knowledge a plus. Knowledge of the Medicare DDE system and able to navigate within that system. Experience correcting claims returned from the provider directly in the DDE system. JOB DUTIES Analyze payer underpayments, variances, and denials. Escalate trends, make comprehensive suggestions, and file professional appeals according to our contractual agreements and UT Southwestern policy. This includes timely processing of allocated volume of accounts, based on established production guidelines and time parameters provided for workflow. Responsible for outbound calls and/or status inquiries via payer%27s website validating receipt of medical claims and adjudication status within established timeframes. Display competent ability to access, navigate, and manage account information through phone calls and payer websites. Documents all work and calls performed, in accordance to policy. This includes complete contact information, good grammar, and expected outcomes. Display competency and ability to work within client based, research, and UTSW special arrangements. This includes, but is not limited to: calculating the physician and hospital share and working with MSP to transfer the physician%27s share to that department, working with other departments at UTSW to properly invoice clients and bill claims for proper adjudication per our agreements. Be knowledgeable on all payer types and effectively work on special projects for specific initiatives for account resolution projects. Demonstrate confidence and sound decision making for processing through large volumes of denials, complex accounts, or contractual reviews, as identified from strategic leadership requirements. Make necessary adjustments as required by plan reimbursement. Function as a departmental liaison for billing and collections support for internal and external customers, as required. Utilize systems tools and department resources to achieve production and quality targets for resolution of patient accounts. Investigates and responds to questions or requests for additional information in a timely and professional manner to ensure proper, timely and accurate payment of patient accounts. Maintains passing QA Scores Attends in-services, classes and meetings related to all operations to the PFS department. Understands reimbursement of all 3rd party payers. 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. 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%27ll discover a culture of teamwork, professionalism, and a rewarding career! 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! Work Schedule: Flexibility start time from 7am-9am thru 3:30pm-5pm. This is a remote position however; candidate must live in the Dallas Fort Worth metroplex due to occasional onsite meetings/trainings. This will be discussed more in the interview. EXPERIENCE AND EDUCATION Required Education High School Diploma and Experience 5 years hospital or medical billing experience. Preferred Education Bachelor%27s Degree Experience Experienced collector for Traditional Medicare with billing experience and EPIC knowledge a plus. Knowledge of the Medicare DDE system and able to navigate within that system. Experience correcting claims returned from the provider directly in the DDE system. JOB DUTIES Analyze payer underpayments, variances, and denials. Escalate trends, make comprehensive suggestions, and file professional appeals according to our contractual agreements and UT Southwestern policy. This includes timely processing of allocated volume of accounts, based on established production guidelines and time parameters provided for workflow. Responsible for outbound calls and/or status inquiries via payer%27s website validating receipt of medical claims and adjudication status within established timeframes. Display competent ability to access, navigate, and manage account information through phone calls and payer websites. Documents all work and calls performed, in accordance to policy. This includes complete contact information, good grammar, and expected outcomes. Display competency and ability to work within client based, research, and UTSW special arrangements. This includes, but is not limited to: calculating the physician and hospital share and working with MSP to transfer the physician%27s share to that department, working with other departments at UTSW to properly invoice clients and bill claims for proper adjudication per our agreements. Be knowledgeable on all payer types and effectively work on special projects for specific initiatives for account resolution projects. Demonstrate confidence and sound decision making for processing through large volumes of denials, complex accounts, or contractual reviews, as identified from strategic leadership requirements. Make necessary adjustments as required by plan reimbursement. Function as a departmental liaison for billing and collections support for internal and external customers, as required. Utilize systems tools and department resources to achieve production and quality targets for resolution of patient accounts. Investigates and responds to questions or requests for additional information in a timely and professional manner to ensure proper, timely and accurate payment of patient accounts. Maintains passing QA Scores Attends in-services, classes and meetings related to all operations to the PFS department. Understands reimbursement of all 3rd party payers. 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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