Remote Eligibility Denial Lead - Medical Billing

The University of Texas Southwestern Medical Center; Dallas (TX); Remote; USD 52,000 - 76,000; Full time

Benefits offered by this job

PPO medical plan

Paid Time Off

Retirement Programs through TRS

Paid Parental Leave Benefit

Wellness programs

Tuition Reimbursement

Public Service Loan Forgiveness (PSLF)

Job summary

UT Southwestern Medical Center is recruiting an Eligibility Denial Specialist III to research and resolve denied insurance claims for both professional and hospital billing based on eligibility. The role includes disputing refunds, communicating with insurance carriers, and ensuring timely billing.

You will manage refunds, lead workflow priorities, and mentor staff while coordinating with payers and patients.

Qualifications

• 6 years medical billing, claims processing, and/or insurance eligibility experience.
• Knowledge of refunds processing and payer requirements.
• Graduate degrees/certifications may substitute for experience.

Responsibilities

• Review and resolve denied claims for eligibility in professional and hospital billing.
• Interpret EOBs and coordinate with payers on denials.
• Contact payers and patients regarding eligibility and COB.
• Lead workflow activities and mentor staff in refund processes.
• Identify root causes of billing issues and propose improvements.

Skills

Refunds management

Payer portals

Insurance billing

Dispute letters

Communication with payers

Registration updates

Multitasking

Training staff

Root cause analysis

Education

High School Diploma or equivalent

Tools

Excel

Billing system

Payer portals

Job description

UT Southwestern Medical Center is recruiting an Eligibility Denial Specialist III to research and resolve denied insurance claims for both professional and hospital billing based on eligibility. The role includes disputing refunds, communicating with insurance carriers, and ensuring timely billing.

You will manage refunds, lead workflow priorities, and mentor staff while coordinating with payers and patients.