Remote Denials and Appeals Specialist II

The University of Texas Southwestern Medical Center; Dallas (TX); Hybrid; USD 55,000 - 75,000; Full time

Job summary

The University of Texas Southwestern Medical Center is seeking a Technical Denials Management Specialist II to review, research, and resolve claim denials and appeals for various insurers. The role emphasizes follow-up and resolution of denied claims, with no direct billing or coding responsibilities.

The successful candidate should have experience in medical claims recovery and hold strong communication, organization, and analytical skills.

Qualifications

• Education: High School Diploma required; Associate degree preferred.
• Experience: 2 years in medical claims recovery/collections required.
• Knowledge: CMS 1500, ICD-9, CPT coding preferred.
• Requires ability to work in a fast-paced, production-oriented environment with strong customer service.

Responsibilities

• Analyze payer denials by denial groupers and submit appeals.
• Contact patients/third-party payers to resolve insurance balances and underpaid claims.
• Make adjustments as required by plan reimbursement.
• Serve as liaison between clinical departments and MSRDP management.
• Complete special projects as assigned and perform other duties as needed.

Skills

Self-starter

Teamwork

Communication

High-volume work

Fast-paced environment

Customer service

Medical billing/collections

Organizational skills

Regulations knowledge

CMS 1500 knowledge

Alpha-numeric data entry

Professional demeanor

Written & verbal communication

Medicare/Medicaid knowledge

Education

High School Diploma

Associate's degree (preferred)

Job description

The University of Texas Southwestern Medical Center is seeking a Technical Denials Management Specialist II to review, research, and resolve claim denials and appeals for various insurers. The role emphasizes follow-up and resolution of denied claims, with no direct billing or coding responsibilities.

The successful candidate should have experience in medical claims recovery and hold strong communication, organization, and analytical skills.