What are the responsibilities and job description for the Reimbursement Specialist - Surgery 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!
JOB SUMMARY
Works under moderate supervision to provide policy analysis and recommendations to management related to reimbursement projects and functions.
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!
Work Schedule: Monday-Friday (8am-5pm). This position is mostly remote but may need to come into the office for meetings, etc. Candidate must live in Texas.
EXPERIENCE AND EDUCATION
Required
Education
High School Diploma or equivalent
Experience
4 years of progressively responsible experience in medical insurance, medical billing or medical reimbursement.
Preferred
Licenses and Certifications
(CPC) CERT PROFESSIONAL CODER Upon Hire or
Advanced Records Technician (ART) Upon Hire or
(RRA) REGISTERED RECORDS ADMIN Upon Hire
JOB DUTIES
Performs policy analysis for managed care issues by reviewing contracts, writing clause revisions, making recommendations for reimbursement policy changes, reviewing reports and financial data, and analyzing fee schedules, encounter forms, diagnosis, and procedure codes; ensures contracts reflect appropriate business decisions.
Ensures projects related to reimbursement issues are completed on time and changes are implemented appropriately by conducting meetings, organizing activities, reviewing data analyses and reports, and creating reimbursement policies and procedures.
Documents findings by writing inquiry letters, constructing opinion letters, maintaining contract files, and maintaining files for research documents.
Performs 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
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.
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
Works under moderate supervision to provide policy analysis and recommendations to management related to reimbursement projects and functions.
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!
Work Schedule: Monday-Friday (8am-5pm). This position is mostly remote but may need to come into the office for meetings, etc. Candidate must live in Texas.
EXPERIENCE AND EDUCATION
Required
Education
High School Diploma or equivalent
Experience
4 years of progressively responsible experience in medical insurance, medical billing or medical reimbursement.
Preferred
Licenses and Certifications
(CPC) CERT PROFESSIONAL CODER Upon Hire or
Advanced Records Technician (ART) Upon Hire or
(RRA) REGISTERED RECORDS ADMIN Upon Hire
JOB DUTIES
Performs policy analysis for managed care issues by reviewing contracts, writing clause revisions, making recommendations for reimbursement policy changes, reviewing reports and financial data, and analyzing fee schedules, encounter forms, diagnosis, and procedure codes; ensures contracts reflect appropriate business decisions.
Ensures projects related to reimbursement issues are completed on time and changes are implemented appropriately by conducting meetings, organizing activities, reviewing data analyses and reports, and creating reimbursement policies and procedures.
Documents findings by writing inquiry letters, constructing opinion letters, maintaining contract files, and maintaining files for research documents.
Performs 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
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.
