Reimbursement Specialist - Ophthalmology Department

Location

Type, TX | United States

Job description

JOB SUMMARY:  

UT Southwestern Medical Center has an opening for a Reimbursement Specialist within the Ophthalmology Department – Clinical Revenue Cycle team.

Work From Home (WFH): This position will involve the opportunity to work from home 90% of the time. Additional details shall be discussed as part of the interview process 

A day in the life for this position will include the following: 

• Abstract charts for correcting chargers in front-end processing. 
• Ability to distinguish difference between medical and routine services for proper billing. 
• Maintains current pricing information for self-pay cosmetic procedures. 
• Provides assistance to front end in finding diagnosis codes or proper CPAT codes. 
• Clear understanding of billing and coding guidelines. 
• Familiar with coding resources available when needing assistance with code selection. 
• Communicates with clinic regarding authorization and diagnosis codes issues. 
• Communicates professionally with residents and faculty in regard to coding and attestation issues. 

EXPERIENCE

REQUIRED:

• High School diploma or GED
• And four (4) years progressively responsible experience in medical insurance, medical billing, or medical reimbursement.
• Certified Professional Coder (CPC), Advanced Records Technician (ART), or Registered Records Administrator (RRA) preferred.
• Any equivalent combination of related education and/or experience may be considered for the above. 

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:

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

UT Southwestern 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; sex; including sexual harassment; age; disability; genetic information; citizenship status; and protected veteran status. In addition, it is UT Southwestern policy to prohibit discrimination on the basis of sexual orientation, gender identity, or gender expression. 

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