Claims Edit Specialist I

%3Cp%3E%3Cstrong%3EWHY UT SOUTHWESTERN?%3C/strong%3E%3Cbr%3EWith 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 %3Ca href=%22https://www.utsouthwestern.edu/newsroom/articles/year-2022/july-us-news-best-hospital.html%22 target=%22_blank%22%3EU.S. News %26amp; World Report%3C/a%3E, 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%27ll discover a culture of teamwork, professionalism, and a rewarding career!%26nbsp;%3Cbr%3E%3Cbr%3E%3Cstrong%3EJOB SUMMARY%3C/strong%3E%3Cbr%3EThis job is responsible for reviewing and processing basic insurance claim edits in a timely manner under direct supervision of supervisor.%26nbsp;%3C/p%3E%3Cul style=%22margin-top:0in;%22 type=%22disc%22%3E%3Cli class=%22MsoNormal%22 style=%22mso-list:l1 level1 lfo1;tab-stops:list .5in;%22%3E%3Cspan style=%22mso-fareast-font-family:%26quot;Times New Roman%26quot;;%22%3EShift - 8-hour, flex shift Monday through Friday%3C/span%3E%3C/li%3E%3Cli class=%22MsoNormal%22 style=%22mso-list:l1 level1 lfo1;tab-stops:list .5in;%22%3E%3Cspan style=%22mso-fareast-font-family:%26quot;Times New Roman%26quot;;%22%3EWork From Home: Although this is a WFH position, the applicant must live in the Greater DFW area.%26nbsp;%3C/span%3E%3C/li%3E%3C/ul%3E%3Cp class=%22MsoNormal%22%3E%3Cstrong%3EOur Culture:%3C/strong%3E%3C/p%3E%3Cp class=%22MsoNormal%22%3EOur teams’ culture is Love Based, which thrives on mutual respect, empathy, and support, fostering an environment where every member feels valued and empowered. It prioritizes open communication, collaboration, and understanding, creating a cohesive and inclusive community where individuals can flourish personally and professionally. Love Based cultivates a culture where kindness, compassion, and appreciation are foundational principles, leading to greater creativity, productivity, and fulfillment for all team members%3C/p%3E%3Cp class=%22MsoNormal%22%3E%3Cstrong%3EJob Expectations:%3C/strong%3E%3C/p%3E%3Cul style=%22margin-top:0in;%22 type=%22disc%22%3E%3Cli class=%22MsoNormal%22 style=%22mso-list:l2 level1 lfo2;tab-stops:list .5in;%22%3E%3Cspan style=%22mso-fareast-font-family:%26quot;Times New Roman%26quot;;%22%3EWork both independently and collaboratively within a team to achieve production goals and deadlines.%3C/span%3E%3C/li%3E%3Cli class=%22MsoNormal%22 style=%22mso-list:l2 level1 lfo2;tab-stops:list .5in;%22%3E%3Cspan style=%22mso-fareast-font-family:%26quot;Times New Roman%26quot;;%22%3EDemonstrate a strong commitment to productivity by staying focused and on task without constant supervision.%3C/span%3E%3C/li%3E%3Cli class=%22MsoNormal%22 style=%22mso-list:l2 level1 lfo2;tab-stops:list .5in;%22%3E%3Cspan style=%22mso-fareast-font-family:%26quot;Times New Roman%26quot;;%22%3EEffectively communicate with colleagues, supervisors, and managers to ensure clarity, alignment, and successful outcomes.%3C/span%3E%3C/li%3E%3Cli class=%22MsoNormal%22 style=%22mso-list:l2 level1 lfo2;tab-stops:list .5in;%22%3E%3Cspan style=%22mso-fareast-font-family:%26quot;Times New Roman%26quot;;%22%3ETake ownership of assigned tasks and projects, demonstrating accountability and reliability in meeting expectations.%3C/span%3E%3C/li%3E%3Cli class=%22MsoNormal%22 style=%22mso-list:l2 level1 lfo2;tab-stops:list .5in;%22%3E%3Cspan style=%22mso-fareast-font-family:%26quot;Times New Roman%26quot;;%22%3EAdapt to changing priorities and work demands while maintaining a high level of quality and efficiency.%3C/span%3E%3C/li%3E%3Cli class=%22MsoNormal%22 style=%22mso-list:l2 level1 lfo2;tab-stops:list .5in;%22%3E%3Cspan style=%22mso-fareast-font-family:%26quot;Times New Roman%26quot;;%22%3EProactively identify opportunities for process improvement and contribute innovative solutions to enhance overall productivity and teamwork%3C/span%3E%3C/li%3E%3C/ul%3E%3Cp class=%22MsoNormal%22%3E%3Cstrong%3EHard Skills%3C/strong%3E%3C/p%3E%3Cul style=%22margin-top:0in;%22 type=%22disc%22%3E%3Cli class=%22MsoNormal%22 style=%22mso-list:l3 level1 lfo3;tab-stops:list .5in;%22%3E%3Cspan style=%22mso-fareast-font-family:%26quot;Times New Roman%26quot;;%22%3EEpic experience%3C/span%3E%3C/li%3E%3Cli class=%22MsoNormal%22 style=%22mso-list:l3 level1 lfo3;tab-stops:list .5in;%22%3E%3Cspan style=%22mso-fareast-font-family:%26quot;Times New Roman%26quot;;%22%3EKnowledge and experience with registration%3C/span%3E%3C/li%3E%3Cli class=%22MsoNormal%22 style=%22mso-list:l3 level1 lfo3;tab-stops:list .5in;%22%3E%3Cspan style=%22mso-fareast-font-family:%26quot;Times New Roman%26quot;;%22%3EKnowledge and experience with health insurance carriers%3C/span%3E%3C/li%3E%3Cli class=%22MsoNormal%22 style=%22mso-list:l3 level1 lfo3;tab-stops:list .5in;%22%3E%3Cspan style=%22mso-fareast-font-family:%26quot;Times New Roman%26quot;;%22%3EAbility to read and understand Explanation of Benefits%3C/span%3E%3C/li%3E%3Cli class=%22MsoNormal%22 style=%22mso-list:l3 level1 lfo3;tab-stops:list .5in;%22%3E%3Cspan style=%22mso-fareast-font-family:%26quot;Times New Roman%26quot;;%22%3EAbility to multitask%3C/span%3E%3C/li%3E%3Cli class=%22MsoNormal%22 style=%22mso-list:l3 level1 lfo3;tab-stops:list .5in;%22%3E%3Cspan style=%22mso-fareast-font-family:%26quot;Times New Roman%26quot;;%22%3EContacting insurance companies and patients%3C/span%3E%3C/li%3E%3C/ul%3E%3Cp class=%22MsoNormal%22%3E%3Cstrong%3ESoft Skills%3C/strong%3E%3C/p%3E%3Cul style=%22margin-top:0in;%22 type=%22disc%22%3E%3Cli class=%22MsoNormal%22 style=%22mso-list:l0 level1 lfo4;tab-stops:list .5in;%22%3E%3Cspan style=%22mso-fareast-font-family:%26quot;Times New Roman%26quot;;%22%3EOutlook experience%3C/span%3E%3C/li%3E%3Cli class=%22MsoNormal%22 style=%22mso-list:l0 level1 lfo4;tab-stops:list .5in;%22%3E%3Cspan style=%22mso-fareast-font-family:%26quot;Times New Roman%26quot;;%22%3ETeam experience%3C/span%3E%3C/li%3E%3Cli class=%22MsoNormal%22 style=%22mso-list:l0 level1 lfo4;tab-stops:list .5in;%22%3E%3Cspan style=%22mso-fareast-font-family:%26quot;Times New Roman%26quot;;%22%3EExcel experience%3C/span%3E%3C/li%3E%3Cli class=%22MsoNormal%22 style=%22mso-list:l0 level1 lfo4;tab-stops:list .5in;%22%3E%3Cspan style=%22mso-fareast-font-family:%26quot;Times New Roman%26quot;;%22%3EMedical Terminology%3C/span%3E%3Cbr%3E%26nbsp;%3C/li%3E%3C/ul%3E%3Cp%3E%3Cstrong%3EBENEFITS%3C/strong%3E%3Cbr%3EUT 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:%3C/p%3E%3Cul%3E%3Cli%3EPPO medical plan, available day one at no cost for full-time employee-only coverage%3C/li%3E%3Cli%3E100% coverage for preventive healthcare-no copay%3C/li%3E%3Cli%3EPaid Time Off, available day one%3C/li%3E%3Cli%3ERetirement Programs through the Teacher Retirement System of Texas (TRS)%3C/li%3E%3Cli%3EPaid Parental Leave Benefit%3C/li%3E%3Cli%3EWellness programs%3C/li%3E%3Cli%3ETuition Reimbursement%3C/li%3E%3Cli%3EPublic Service Loan Forgiveness (PSLF) Qualified Employer%3C/li%3E%3Cli%3E%3Ca href=%22http://jobs.utsouthwestern.edu/benefits/#top%22 target=%22_blank%22%3ELearn more about these and other UTSW employee benefits!%3C/a%3E%3C/li%3E%3C/ul%3E%3Cp%3E%3Cbr%3E%3Cbr%3E%3Cstrong%3EEXPERIENCE AND EDUCATION%3C/strong%3E%3Cbr%3E%3Cbr%3E%3Cstrong%3ERequired%3C/strong%3E%3C/p%3E%3Cul%3E%3Cli%3E%3Cstrong%3EEducation%3C/strong%3E%3Cbr%3EHigh School Diploma or equivalent%26nbsp;%3Cbr%3E%26nbsp;%3C/li%3E%3C/ul%3E%3Cul%3E%3Cli%3E%3Cstrong%3EExperience%3C/strong%3E%3Cbr%3E2 years of experience with medical billing or claims processing, knowledge of billing and/or collections rules and regulations%26nbsp;%3Cbr%3EMay consider education in lieu of experience.%26nbsp;%3C/li%3E%3C/ul%3E%3Cp%3E%3Cbr%3E%3Cstrong%3EJOB DUTIES%3C/strong%3E%3C/p%3E%3Cul%3E%3Cli%3EReviews and processes basic insurance claim edits through the billing system for registration and demographic accuracy.%3C/li%3E%3Cli%3EUtilizes vendor and third party websites for eligibility and benefit verification, including update of registration information within the billing system.%3C/li%3E%3Cli%3EReposts and resubmits claims based on research findings and billing system updates.%3C/li%3E%3Cli%3EWorks in all professional billing service areas.%3C/li%3E%3Cli%3EUpdates registration and demographic information in at least two hospital billing service areas.%3C/li%3E%3Cli%3EEscalates issues above knowledge base to higher level specialist or supervisor.%3C/li%3E%3Cli%3EDuties performed may include one or more of the following core functions: (a) Directly interacting with or caring for patients; (b) Directly interacting with or caring for human-subjects research participants; (c) Regularly maintaining, modifying, releasing or similarly affecting patient records (including patient financial records); or (d) Regularly maintaining, modifying, releasing or similarly affecting human-subjects research records.%3C/li%3E%3Cli%3EPerforms other duties as assigned.%3C/li%3E%3C/ul%3E%3Cp%3E%3Cstrong%3ESECURITY AND EEO STATEMENT%3C/strong%3E%3Cbr%3E%3Cbr%3E%3Cstrong%3ESecurity%3C/strong%3E%3Cbr%3EThis position is security-sensitive and subject to Texas Education Code 51.215, which authorizes UT Southwestern to obtain criminal history record information.%3Cbr%3E%3Cbr%3E%3Cstrong%3EEEO%3C/strong%3E%3Cbr%3EUT 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.%3Cbr%3E%26nbsp;%3C/p%3E