Claims Edit Specialist II

UT Southwestern Medical Center; Dallas (TX); On-site; USD 52,000 - 72,000; Full time

Benefits offered by this job

PPO medical plan

Paid Time Off

Tuition Reimbursement

Public Service Loan Forgiveness (PSLF)

Wellness programs

Job summary

UT Southwestern Medical Center in Dallas is seeking a Claims Edit Specialist to review and process insurance claim edits under supervision. This role requires strong billing knowledge and the ability to navigate health insurance processes to ensure accurate claims handling.

The position emphasizes accuracy, timely task completion, and collaboration within the team. A high school diploma and roughly four years of medical billing experience are expected, with a shift of 8 hours per day in a day

Qualifications

• Education High School Diploma Or equivalent.
• Experience 4 years Experience with medical billing or claims processing, knowledge of billing and/or collections rules and regulations and May consider education in lieu of experience

Responsibilities

• Reviews and processes basic and complex insurance claim edits through the billing system.
• Utilizes vendor and third party websites for eligibility/benefit verification and authorization information. Updates the billing system accordingly.
• Reposts and resubmits claims based on research findings and billing system updates.
• Works in all professional billing service areas.
• Updates registration and demographic information in at least two hospital billing service areas.
• Assists lower level specialists. May elevate issues above knowledge base to higher level specialist or supervisor.
• 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.

Skills

Epic experience

Registration knowledge

Health insurance knowledge

Explanation of Benefits reading

Multitasking

Contacting insurers & patients

Outlook

Team experience

Excel

Medical terminology

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 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 Claims Edit Specialist is responsible for reviewing and processing basic and complex insurance claim edits in a timely manner under direct supervision of supervisor. This position works under direct supervisor of the department supervisor and is expected to complete assigned claims in a timely manner while following established procedures and guidelines.

• Candidate must live in the Greater Dallas-Fort Worth (DFW) area.
• Shift: 8-hour days, flex shift

Our Culture

Our team’s 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

• Work both independently and collaboratively within a team to achieve production goals and deadlines.
• Demonstrate a strong commitment to productivity by staying focused and on task without constant supervision.
• Effectively communicate with colleagues, supervisors, and managers to ensure clarity, alignment, and successful outcomes.
• Take ownership of assigned tasks and projects, demonstrating accountability and reliability in meeting expectations.
• Adapt to changing priorities and work demands while maintaining a high level of quality and efficiency.
• Proactively identify opportunities for process improvement and contribute innovative solutions to enhance overall productivity and teamwork.

Hard Skills

• Epic experience
• Knowledge and experience with registration
• Knowledge and experience with health insurance carriers
• Ability to read and understand Explanation of Benefits
• Ability to multitask.
• Contacting insurance companies and patients

Soft Skills

• Outlook experience
• Team experience
• Excel experience
• Medical Terminology

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!

Required

EXPERIENCE AND EDUCATION

• Education High School Diploma Or equivalent
• Experience 4 years Experience with medical billing or claims processing, knowledge of billing and/or collections rules and regulations and May consider education in lieu of experience

Job Duties

• Reviews and processes basic and complex insurance claim edits through the billing system.
• Utilizes vendor and third party websites for eligibility/benefit verification and authorization information. Updates the billing system accordingly.
• Reposts and resubmits claims based on research findings and billing system updates.
• Works in all professional billing service areas.
• Updates registration and demographic information in at least two hospital billing service areas.
• Assists lower level specialists. May elevate issues above knowledge base to higher level specialist or supervisor.
• 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

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.

Primary Location

Texas-Dallas-5323 Harry Hines Blvd

Work Locations

5323 Harry Hines Blvd

Job

Insurance/Billing

Organization

713007 - MG Rev Cyc Follow Up

Schedule

Full-time

Shift

Day Job

Job Type

Standard

Job Level

Individual Contributor

Job Posting

Sep 22, 2026, 4:11:44 AM