What are the responsibilities and job description for the Patient Financial Services Rep I position at UT Southwestern?
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!
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!
Candidate must live in the Dallas/Fort Worth metroplex
Work Shift: Flexible start (Between 6am-8:30am) - Monday-Friday, 8-hour workday. Work from home 90% but will need to go into the office once a week.
EXPERIENCE AND EDUCATION
Required
Education
High School Diploma and
Experience
2 years hospital or medical billing experience
Preferred
Education
Bachelor's Degree
JOB DUTIES
Ensure all claims are billed and received by the payers for proper adjudication. This includes timely processing of allocated volume of accounts, based on established production guidelines and time parameters provided for workflow.
Responsible for outbound calls and/or status inquiries via payer's website validating receipt of medical claims and adjudication status within established timeframes. Display competent ability to access, navigate, and manage account information through phone calls and payer websites.
Work any edits and denials in allocated workflow to achieve proper adjudication to payment. This includes, but is not limited to: verify insurance is correct, update insurance demographics, rebill claims not received, document the status of work performed, follow-up on outstanding adjudication items according to departmental guidelines, and is also responsible for billing secondary/tertiary claims along with providing supporting documentation to payers for additional payment.
Documents all work and calls performed, in accordance to policy. This includes complete contact information, good grammar, and expected outcomes.
Obtain primary and/or secondary EOB and claims to bill next responsible payer, along with utilizing various internal resources to obtain medical records to respond to requests from payers upon request.
Utilize systems tools and department resources to achieve production and quality targets for resolution of patient accounts.
Investigates and responds to questions or requests for additional information in a timely and professional manner to ensure proper, timely and accurate payment of patient accounts.
Maintains passing QA Scores
Attends in-services, classes and meetings related to all operations to the PFS department. Understands reimbursement of all 3rd party payers.
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. 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!
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!
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!
Candidate must live in the Dallas/Fort Worth metroplex
Work Shift: Flexible start (Between 6am-8:30am) - Monday-Friday, 8-hour workday. Work from home 90% but will need to go into the office once a week.
EXPERIENCE AND EDUCATION
Required
Education
High School Diploma and
Experience
2 years hospital or medical billing experience
Preferred
Education
Bachelor's Degree
JOB DUTIES
Ensure all claims are billed and received by the payers for proper adjudication. This includes timely processing of allocated volume of accounts, based on established production guidelines and time parameters provided for workflow.
Responsible for outbound calls and/or status inquiries via payer's website validating receipt of medical claims and adjudication status within established timeframes. Display competent ability to access, navigate, and manage account information through phone calls and payer websites.
Work any edits and denials in allocated workflow to achieve proper adjudication to payment. This includes, but is not limited to: verify insurance is correct, update insurance demographics, rebill claims not received, document the status of work performed, follow-up on outstanding adjudication items according to departmental guidelines, and is also responsible for billing secondary/tertiary claims along with providing supporting documentation to payers for additional payment.
Documents all work and calls performed, in accordance to policy. This includes complete contact information, good grammar, and expected outcomes.
Obtain primary and/or secondary EOB and claims to bill next responsible payer, along with utilizing various internal resources to obtain medical records to respond to requests from payers upon request.
Utilize systems tools and department resources to achieve production and quality targets for resolution of patient accounts.
Investigates and responds to questions or requests for additional information in a timely and professional manner to ensure proper, timely and accurate payment of patient accounts.
Maintains passing QA Scores
Attends in-services, classes and meetings related to all operations to the PFS department. Understands reimbursement of all 3rd party payers.
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. 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!
