Billing Specialist III

UT Southwestern Medical Center; United States; Hybrid; USD 52,000 - 76,000; Full time

Benefits offered by this job

PPO medical plan

100% preventive care coverage

Paid Time Off

Retirement programs (TRS)

Paid Parental Leave

Wellness programs

Tuition reimbursement & PSLF eligible

Job summary

UT Southwestern Medical Center is seeking a Billing Specialist III in the Revenue Cycle Department. This role supports nephrology billing and works under moderate supervision to manage complex billing responsibilities.

Responsibilities include reviewing charges, reconciling accounts, and ensuring timely submissions. The position allows WFH with locality restrictions; shift is flexible 8-hour days Monday–Friday.

Qualifications

• Education: High School Diploma or equivalent.
• Experience: 3 years medical billing or collections experience.
• Must demonstrate the ability to work complex E&M services, complex diagnostic studies, endoscopic, interventional and/or surgical procedures.
• Must demonstrate the ability to make calls to obtain authorizations.

Responsibilities

• Analyze, investigate and resolve coding edits for complex billing scenarios across procedures.
• Perform abstracting on E&M services and related procedures requiring CPT/diagnosis/modifier adjustments.
• Execute monthly charge reconciliation.
• Serve as a resource to the billing team and provide guidance on denial resolutions.
• Perform manual charge entry for non-EpicCare sites when required.

Skills

Medical billing

Authorization calls

E/M coding

Team collaboration

Education

High School Diploma or equivalent

Job 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 No. 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

UT Southwestern Medical Center has a new opportunity in the Revenue Cycle Department for a Billing Specialist III. Works under moderate supervision to perform advanced level billing responsibilities. Supports the division of Nephrology.

The duties for this position will include but not limited to the following:

• Maintain a monthly average of 115 encounters per day.
• Excellent time management skills
• Ability to partner with a team or work alone.
• Charge review
• Reconciliation
• Manual charge entry
• Ensure the department adheres to a six-day metric.
• Work From Home (WFH): This position will work from home, but the applicant must live within the Dallas/Fort Worth area. Additional details shall be discussed with applicants during the interview process.
• Shift: Flex shift, 8-hour days Monday - Friday

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 ReimbursementPublic Service Loan Forgiveness (PSLF) Qualified Employer
• Learn more about these and other UTSW employee benefits!

EXPERIENCE AND EDUCATION

Required

• Education: High School Diploma or equivalent.
• Experience: 3 years medical billing or collections experience
• Must demonstrate the ability to work complex E&M services, complex diagnostic studies, endoscopic, interventional and/or surgical procedures
• Must demonstrate the ability to make calls to obtain authorizations

Preferred

• Education: Coding certifications (CPC, CPMA, CMC, ART, RRA, RHIA, RHIT, CCS, CCA) and/or degrees (associate level, bachelor level, master level) preferred and may be considered in lieu of experience.
• Licenses and Certifications: (CPC) CERT PROFESSIONAL CODER Upon Hire or (CPMA) Cert Prof Medical Auditor Upon Hire or (CMC) CERT MEDICAL CODER Upon Hire or (ART) ASSOC RECORDS ADMIN Upon Hire or (RRA) REGISTERED RECORDS ADMIN Upon Hire or (RHIA) REGD HEALTH INFO ADMINIST Upon Hire or (RHIT) REGD HEALTH INFO TECHNOLO Upon Hire or (CCS) CERT CODING SPECIALIST Upon Hire or (CCA) Cert Coding Associate Upon Hire

JOB DUTIES

• Analyzes, investigates and resolves coding edits for complex drug billing, complex diagnostic studies, endoscopic, interventional and/or surgical procedures. This includes CPT, diagnosis, modifier, bundling, duplicate charge, and custom edit resolution. Requires strong knowledge of the carrier's (Federal/State/Private) regulations and guidelines, internal revenue cycle coding processes and specialty specific service line billing practices. This position requires a high degree of organization and accuracy, and clear communication with providers on a regular basis to insure services are well documented and meet all billing requirements. This position could possibly require resolving clinical and/or technical denials as well.
• Performs abstracting on E&M services, complex diagnostic studies, and/or endoscopic, interventional or surgical procedures. Requires the ability to read the progress note and or procedure/surgical results and confirm or change the CPT code(s), diagnosis code(s) and modifiers (if applicable). Requires strong knowledge of the carrier coverage policies and documentation requirements for specialty specific service lines. Must know the Medicare and Medicaid teaching physician documentation billing rules.
• Perform monthly charge reconciliation.
• Serves as a resource to the FERC Team Leads, Compliance Auditors, Medical Collectors and Billing Specialists I & II. Requires a billing and coding knowledge level that provides guidance on and resolution to resolve claim denials, rejections and backend coding edits.
• 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 co