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!
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!
About Revenue Cycle Department (Cancer Center)
In cancer care at UT Southwestern, the Revenue Cycle Department plays a vital role in managing the financial complexities associated with oncology treatments. This department works closely with clinical teams to ensure that specialized services, such as chemotherapy, and surgery, are authorized, accurately documented, and billed. This collaboration helps prevent denials and secures funding for essential treatments, enabling smoother workflows for urgent or high-priority oncology cases. The team's efforts are key to supporting patients through the financial aspects of cancer care, ensuring compliance and optimizing revenue specific to oncology services.
The Revenue Cycle Department at the UT Southwestern Medical Center has an opportunity available for a Reimbursement Specialist. This position is a key member of the Simmons Cancer Center Department's authorization team. The duties for this position will include but not be limited to the following:
- Insurance Verification: Checking patients' insurance benefits and coverage for specific infusion therapies and surgeries to ensure treatments are covered under their plan.
- Authorization Requests: Initiate, track, and secure authorizations from insurance companies for oncology treatments, and surgeries.
- Communication with clinical and support staff: Reimbursement Specialist communicate updates regarding authorizations to physicians, infusion schedulers, and other clinical/support staff to ensure that everyone involved in the patient's care is aware of any authorization requirements or issues.
- Documentation and Compliance: Maintain thorough records of all communications with insurance providers and ensuring that all documentation meets regulatory standards and institutional policies.
- Resolving Authorization Issues: Address denials or issues in real-time to prevent delays in treatment, sometimes through appeals or expedited authorization requests if necessary. Obtain retro-authorizations for expired treatment/therapy plans.
Work From Home (WFH): The applicant is expected to work from home, estimated at 90% of the time. However, additional details shall be discussed as part of the interview process.
Applicant must live in the Greater DFW area
Shift: TBD: Possibly 7:30a-4pm, 8am-4:30pm or 8:30a-5pm (Monday thru Friday) including 30-minute lunch break
The ideal candidate for this role will have the following attributes:
- Work independently with little intervention.
- Manage a workload of assignments and meet timeframes
- Experience with EPIC.
- Awareness of insurance plans, medical policies, and authorization portals (i.e. Availity, Encoder, and Carelon).
- Excellent communication both orally and in writing.
- Must be a team player.
- Oncology authorization experience is preferred but not required.
EXPERIENCE AND EDUCATION
Required
- Education
High School Diploma or GED.
- Experience
4 years of progressively responsible experience in medical insurance, medical billing or medical reimbursement.
Preferred
- Licenses and Certifications
(CPC) CERT PROFESSIONAL CODER or
(ART) ASSOC RECORDS ADMIN or
(RRA) REGISTERED RECORDS ADMIN
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 Statement
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.
University of Texas Southwestern Medical Center
medical insurance, parental leave, paid time off, paid holidays, tuition reimbursement, remote work
Jan 15, 2025