Patient Financial Services Rep II - Traditional Medicare Billing & 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'll 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: Felxibility 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 occassional 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's 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's 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's 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.