Remote Denials & Appeals Specialist II

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

Job summary

UT Southwestern Medical Center in Dallas, TX, seeks a Technical Denials Management Specialist II to review, research, and resolve claim denials and appeals for various insurers, maximizing collections. The role emphasizes follow-up and resolution of denied claims with no direct billing or coding duties.

The successful candidate will analyze EOBs, contact payers, and prepare/submitting appeals, working within the Revenue Cycle Department.

Qualifications

• Education: High School Diploma or equivalent.
• Experience: 2 years' experience in medical claims recovery and/or collections.
• Preferred: Associate's degree.

Responsibilities

• Analyze payer denials by denial groupers and submit appeals.
• Contact patients and/or third-party payers to resolve outstanding insurance balances and underpaid claims.
• Make necessary adjustments as required by plan reimbursement.
• Functions as a liaison between clinical departments and MSRDP management team.
• Completes special projects as assigned.
• Performs other duties as assigned.

Skills

EOB review

Payer denials

Appeals submission

Insurance verification

Medical billing

Accounts Receivable

Communication skills

Data entry

Education

High School Diploma

Associate's degree

Tools

CMS 1500

ICD-9

CPT coding

Job description

UT Southwestern Medical Center in Dallas, TX, seeks a Technical Denials Management Specialist II to review, research, and resolve claim denials and appeals for various insurers, maximizing collections. The role emphasizes follow-up and resolution of denied claims with no direct billing or coding duties.

The successful candidate will analyze EOBs, contact payers, and prepare/submitting appeals, working within the Revenue Cycle Department.