Billing Specialist II

The University of Texas Southwestern Medical Center; Dallas (TX); Remote; USD 40,000 - 70,000; Full time

Job summary

Join a world-renowned medical and research center as a Billing Specialist II, where you will play a vital role in managing refund requests and resolving billing discrepancies. This position offers the opportunity to work within a supportive environment that values teamwork and compassion. Your expertise in medical billing and insurance processes will be crucial as you analyze claims, communicate with insurance providers, and ensure compliance with company policies. With a commitment to employee development and a comprehensive benefits package, this role is perfect for those looking to grow their career in the healthcare industry while making a meaningful impact on patient care.

Benefits

PPO medical plan

Paid Time Off

Retirement Programs

Paid Parental Leave

Wellness programs

Tuition Reimbursement

Public Service Loan Forgiveness

Qualifications

• 2 years of medical billing or collections experience required.
• Knowledge of insurance billing practices and regulations is essential.

Responsibilities

• Review and resolve refund requests from insurance carriers.
• Communicate effectively with insurance carriers to resolve issues.

Skills

Medical billing

Insurance claim resolution

Communication skills

Attention to detail

Multitasking

Education

High School Diploma or equivalent

Associate's Degree

Bachelor's Degree

Master's Degree

Tools

Epic

Payer Portals

Excel

Job description

Job Description

Description

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 Billing Specialist II works under moderate supervision to perform intermediate level billing responsibilities. This position will be responsible for managing and resolving outstanding correspondence related to refund requests from insurance carriers. This role involves reviewing refund requests, determining their validity, disputing questionable refunds, and communicating directly with insurance companies to resolve issues. The individual will also be tasked with completing dispute letters, conducting follow-ups, and handling appeals to ensure proper resolution of refund issues. Experience in insurance billing, registration, and a keen understanding of the refund process will be key to successfully managing these tasks. This position requires strong attention to detail, the ability to effectively communicate with insurance carriers, and a solid understanding of billing and refund processes within the healthcare industry.

Our Culture:

Our teams culture is Love Based, which thrives on mutual respect, empathy, and support, fostering an environment where every member feels valued and empowered. It prioritizes open communication, collaboration, and understanding, creating a cohesive and inclusive community where individuals can flourish personally and professionally. Love Based cultivates a culture where kindness, compassion, and appreciation are foundational principles, leading to greater creativity, productivity, and fulfillment for all team members.

Job Expectations:

• Review and resolve refund request correspondence from insurance carriers, analyzing claims and documentation to determine validity.
• Dispute questionable refunds by researching and presenting evidence to insurance carriers and submitting dispute letters when necessary.
• Contact insurance carriers to resolve refund issues, follow up regularly to track the status, and manage the appeals process for incorrect or denied refunds.
• Process and issue refunds, ensuring compliance with company policies and accurate transactions.
• Utilize insurance billing knowledge to address discrepancies and leverage registration experience to resolve issues impacting refunds.
• Update insurance, registration, and vfo to ensure charges are billed to correct insurance.

Hard Skills

• Experience with reviewing and resolving refund request correspondence from various insurance carriers.
• Knowledge and experience with submitting dispute letters to insurance carriers and following up to track the status of refund disputes.
• Knowledge and experience in processing and issuing refunds in compliance with company policies, along with a strong understanding of insurance billing practices and regulations to resolve billing discrepancies.
• Ability to communicate effectively with insurance carriers via phone or written communication to resolve refund issues.
• Experience with online payer portals to manage refund requests and disputes.
• Knowledge of registration processes to resolve issues impacting patient or insurance account details related to refunds.
• Ability to multitask and prioritize tasks effectively while managing multiple refund disputes and requests.

Soft Skills

• Excel experience
• Medical Terminology
• Payer Portal experience

Work from home: The candidate will work from home but must live within the Greater DFW area. Additional details to be discussed during the interview.

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
• 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

Education
High School Diploma or equivalent.

Experience
2 years Medical billing or collections experience. Coding certifications (CPC, CPMA, CMC, ART, RRA, RHIA, RHIT, CCS, CCA) and/or degrees (associate level, bachelor level, master level) preferred and may be used in lieu of experience.

Preferred

• Education
  Associate's Degree or Bachelor's Degree or Master's Degree
• Licenses and Certifications
  Coding certifications (CPC, CPMA, CMC, ART, RRA, RHIA, RHIT, CCS, CCA) Upon Hire

JOB DUTIES

• Analyzes, investigates and resolves coding edits for E&M services, diagnostic studies, and minor surgical procedures. This includes CPT, diagnosis, modifier, bundling, duplicate charge, and custom edit resolution. Requires knowledge of the carrier's (Federal/State/Private) regulations and guidelines, internal revenue cycle coding processes and be familiar with the billing practices of the specialty service line. This position requires a high degree of organization and accuracy and requires clear communication with providers on a regular basis to ensure visits are well documented and meet all billing requirements.
• Performs limited abstracting on E&M services, diagnostic studies, and moderate to minor surgical procedures. Requires the ability to read the progress note and or procedure results and confirm or change the CPT code(s), diagnosis code(s) and modifiers (if applicable). Requires knowledge of the carrier coverage policies and be familiar with the billing practices of the specialty service line. Must be familiar with the Medicare and Medicaid teaching physician documentation billing rules.
• Performs monthly charge reconciliation.
• Investigates and resolves coding and registration Epic Resolute Claim edits. Requires strong knowledge of Epic's carrier registration filing order rules and billing rules.
• Performs manual charge entry for all non-EpicCare and non-automated sites of services. This includes E&M visits and procedures across several centralized service lines. Depending on the clinical department they may be required to review and release charges from a computer assisted coding environment.
• May assist in obtaining insurance authorizations and accurately maintaining the authorization records, communicate patient balance and patient-responsibility amounts to clinics and/or patient/families, responding to requests for information. Attend coding and billing in-services to stay current on changes; attend other meetings and training as assigned.
• 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-subjects 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-subjects research records.
• Performs 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 Statement
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.

Copyright 2017. The University of Texas Southwestern Medical Center 5323 Harry Hines Blvd., Dallas, Texas 75390 Phone [phone]