Customer Service Rep Wound Care Clinic

Location

Type, TX | United States

Job description

Customer Service Representative Wound Care Clinic Full Time Days

Why UTSW? UT Southwestern is committed to our mission to discover, educate and heal. With over 75 years of excellence in Dallas-Fort Worth, we strive to provide the best possible care and resources for the community. Ranked as the #1 hospital in Dallas-Fort Worth for the fifth consecutive year, we invite you to continue your nursing career with UT Southwestern. As the largest certified Wound Ostomy Nurse team in North Texas and DFW, join a culture of teamwork, professionalism, and consistent opportunities for learning and leadership development.

Job Summary

As the Customer Service Rep in our busy Wound Care Clinic, you will be the face of our department at the main desk. You will assist patients and families with check in and check out, answer our phone lines and work with the clinical Staff with patient related issues. We are committed to providing exceptional treatments for our diverse patients with complex and nonhealing wounds and a large new ostomate patient population.

Job Duties

• Provides response to inbound claims inquiries from patients, physicians and other entities. Assures all behavioral care inbound telephone claims calls are directed to this employee as first point of contact. Provides back up relief for ACD telephone lines. 
• Works patient account, including but not limited to, adjustments on small balances, transfers credit balances to debit balances, changes FSC\’s on invoices to reflect different status, and/or requests monetary refunds. Sets up accounts on budget plan. Calls clinics for possible personal courtesy or incorrect entries on invoices. Supplies patients with application for financial assistance. 
• Works directly with patients regarding their account. Provides patients with copies of their statement and reviews them in detail. Makes certain that patient and family member fully understands how to read statement. 
• Calls insurance companies for patients regarding non-payments and other pertinent information. Files and re-files claims, requests EOB\’s from primary and secondary insurance companies and or appeal claims. Acts as liaison between patients and follow up teams. 
• Registers and changes pertinent information in IDX system. Registers patients and updates insurance/demographic information. 
• Assists clinics and patients with managed care information, which requires thorough understanding of managed care guidelines. Records and receipts payments on account from walk-ins and credit card payments over phone. Discusses accounts with walk-in patient as needed. 
• Reviews and processes patient correspondence. Contacts departments for additional information or to resolve issues. Follows up with insurance as needed. Analyzes claim history to detect potential errors in processing. Determines reasons for denials. Responds to special requests for information. Identifies trends in call type and makes recommendations to management. Informs management of trends regarding statement and/or follow up issues. 
• Provides administrative support to department which includes word processing, mail distribution, copying, etc. Provides support for claims processing backlog. 
• Manages all incoming calls and logs into problem tracking database. Maintains problem tracking database. Ensures customer problems receive proper attention and notifies management of problems that may require extra attention. 
• Researches, analyzes and responds to customer inquiries regarding mental health claims processing. Develops, implements flexible innovative solutions. Prepares and maintains departmental documentation as directed by management. 
• Performs other duties as assigned. 

Education and Experience

High School diploma or equivalent and four (4) years experience in medical billing, customer service, claims processing or related field; OR Two (2) years of college and two (2) years experience as stated above is required.

To learn more about the benefits UT Southwestern offers visit

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. 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. To learn more, please visit:

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Salary