Billing Specialist II - Revenue Cycle

Location

Type, TX | United States

Job description

JOB SUMMARY:

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 patients and employees. With over 20,000 employees, we are committed to continuing our growth with the best professionals in the healthcare industry. We invite you to be a part of the UT Southwestern team where you’ll discover teamwork, professionalism, and consistent opportunities for growth.

The team has seven (7) Coding Specialists, three (3) Billing Specialists, one (1) Team Lead, and one (1) Supervisor on the Radiology team. This position reports to the Supervisor. Duties for this position will include but not be limited to the following:

• Resolve charge review warnings
• Resolve edits Claim edits Coding X-ray reports
• Complete all work timely

Shift Flex (details to be discussed during the interview process) 

Work from home (WFH) position. Applicants must live within the state of Texas. Additional details shall be discussed as part of the interview process

EXPERIENCE | EDUCATION:

REQUIRED:

• High School diploma or equivalent
• And two (2) years medical billing or collections experience
• Must demonstrate the ability to work complex E&M services, diagnostic studies, and/or minor surgical procedures
• Must demonstrate the ability to make calls to obtain authorizations.
• Coding certifications (CPC, CPMA, CMC, ART, RRA, RHIA, RHIT, CCS, CCA) and/or degrees (associate level, bachelor level, master level) preferred and may be used in lieu of experience. 

JOB DUTIES:

• Analyzes, investigates and resolves coding edits for E&M services, diagnostic studies, and minor surgical procedures. This includes CPT, diagnosis, modifier, bundling, duplicate charge, and custom edit resolution. Requires knowledge of the carrier’s (Federal/State/Private) regulations and guidelines, internal revenue cycle coding processes and be familiar with the billing practices of the specialty service line. This position requires a high degree of organization and accuracy and requires clear communication with providers on a regular basis to insure visits are well documented and meet all billing requirements.
• Performs limited abstracting on E&M services, diagnostic studies, and moderate to minor surgical procedures. Requires the ability to read the progress note and or procedure results and confirm or change the CPT code(s), diagnosis code(s) and modifiers (if applicable). Requires knowledge of the carrier coverage policies and be familiar with the billing practices of the specialty service line. Must be familiar with the Medicare and Medicaid teaching physician documentation billing rules.
• Performs monthly charge reconciliation.
• Investigates and resolves coding and registration Epic Resolute Claim edits. Requires strong knowledge of Epic’s carrier registration filing order rules and billing rules.
• Performs manual charge entry for all non-Epic Care and non-automated sites of services. This includes E&M visits and procedures across several centralized service lines. Depending on the clinical department they may be required to review and release charges from a computer assisted coding environment.
• May assist in obtaining insurance authorizations and accurately maintaining the authorization records, communicate patient balance and patient-responsibility amounts to clinics and/or patient/families, responding to requests for information. Attend coding and billing in-services to stay current on changes; attend other meetings and training as assigned.
• Duties 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.
• Performs other duties as assigned. 

KNOWLEDGE, SKILLS & ABILITIES:

• Work requires working knowledge of Epic Resolute, Epic Care, and Epic CPOE.
• Work requires working knowledge of MS Excel.
• Work requires ability to analyze problems, develop solutions, and implement new procedures.
• Work requires ability to prioritize large volumes of work.
• Work requires good communication skills.

WORKING CONDITIONS:

Work is performed primarily in general office/clinic area.

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 exp

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