Clinical Denials Specialist

UT Southwestern Medical Center - Dallas, TX3.9

Job Number: 328259
Category: Professional & Executive
Location: 5323 Harry Hines Blvd, Dallas, TX
Department: 844106 - Decision Support
Full/Part Time/PRN: Day Job
Regular/Temporary: Regular
Schedule: Per Diem - PRN


This position is security-sensitive and subject to Texas Education Code 51.215, which authorizes UT Southwestern to obtain criminal history record information


Salary Negotiable

Experience and Education

Two year degree in related field required. Experience in a revenue cycle role that includes denial management, knowledge of coding, medical record documentation, Gvt. billing requirements or five (5) years experience in hospital revenue cycle and claim appeals.
Licensure as Registered Nurse or LVN by State of Texas Preferred.

Job Duties

Collect and review denial information to formulate appeals, sending appeal correspondence_and essential documentation to appropriate carrier.
Perform patient account research to prevent billing rejections,work with various departments as needed.
Analyze final claim denials to determine internal weakness in the organization and assist in developing action plans to avoid future denials.
Develop reports/ feedback to be presented to Denials Management team and the monthly Committee Against Denials meeting.
Assist as needed with chart audits, comparing the medical record against the patient's itemized bill to ensure complete and accurate charge capture.
Complete special projects as identified and needed.
Performs other duties as assigned.

**Other Duties: Performs other duties as assigned.

UTSouthwestern Medical Center is committed to an educational and working environment that provides equal opportunity to all members of the University community. In accordance with federal and state law, the University prohibits unlawful discrimination, including harassment, on the basis of: race; color; religion; national origin; gender, including sexual harassment; age; disability; citizenship; and veteran status. In addition, it is UTSouthwestern policy to prohibit discrimination on the basis of sexual orientation, gender identity, or gender expression.