Clinical Coding DRG Denials Specialist

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 DRG Denials Specialist primary responsibilities are to support all Denials workflows and assignments, follow-up on submitted appeals, assist in escalation of appeals, assist Supervisor to analyze and report denials data, trends, and opportunities for education. The DRG Denials Specialist will track and trend front-end activities that influence the denials/appeals process, seeking opportunities for process improvement. This role will collaborate with Clinical and Coding DRG Denials Analysts for workflow efficiency, identify opportunities for optimization, and report these trends/opportunities to the Supervisor.

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!

EXPERIENCE AND EDUCATION
Required

• Education
  Bachelor's Degree in Health Information Management and/or closely related field.

• Experience
  3 years Acute hospital-based coding and/or CDI experience. An equivalent combination of education and experience may be considered.
  Experience working in a remote environment.

• Licenses and Certifications
  (CCDS) Cert Clinical Documentation Upon Hire or
  (CDIP) CERT DOCUMNTATN IMPROVMNT PRAC Upon Hire or
  (CCS) CERT CODING SPECIALIST Upon Hire or
  (CIC) Certified Inpatient Coder Upon Hire

Preferred

• Experience
  Candidates local to Greater DFW area (or willingness to travel to campus) as needed, on a limited basis.

JOB DUTIES

• Support all Denials workflow and assignments.
• Timely follow-up of submitted appeals.
• Timely recording of incoming denials.
• Provides moderately complex administrative skills for the DRG Denials team.
• Support process improvement to ensure effective/efficient workflows.
• Analyze Denials data, identify trends, and opportunities for education and report to Supervisor.
• Identify front-end activities that influence denial/appeals process.
• Provide backup for other Denials Analyst duties as needed.
• Support the Quality Standards set by UTSW and the HIM Coding & CDI Department.
• Maintain an expert level of knowledge of Coding, CDI, Denials, and Appeal guidelines and practices.
• 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 Statement
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.