[Hiring] Account Auditor @UT Southwestern Medical Center

Role Description

Researches and resolves credit balance accounts resulting from errors in payment posting, charge entry, contractual adjustments, and overpayments.

• Analyze all payer underpayments, variances and denials.
• Resolves all insurance companies refund request letters received.
• Work From Home (WFH): This is a work from home position. However, candidates must live in the Greater DFW area.
• Shift: 8-hour days flex shift, Monday through Friday.

Qualifications

• High School Diploma.
• 5 years' experience performing follow-up/collections, payment posting, appeals and managed care contract understanding/interpretation.
• May consider education in lieu of experience.
• Preferred: 2 years related work experience performing appeals and managed care contract understanding/interpretation.

Requirements

• Reviews patient accounts for incorrect posting and provide orientation and training for staff to contact insurance companies, patients and research insurance payments to identify and correct posting errors.
• Validate and issue refunds to patients and third-party carriers for overpayment or duplicate payment, according to state regulations and contractual obligations.
• Analyze payer underpayments, variances and denials. Escalate trends, make comprehensive suggestions and file professional appeals according to our contractual agreements and UT Southwestern policy.
• Identifies and denies any refund request letters that are past the insurance refund deadline.
• Appropriately transfer payments between invoices and/or accounts.
• Communicate, approve, and reject refund requests to payers and third-party carriers, via phone call and written correspondence.
• Verifies insurance is correct, update insurance demographics, rebill claims and perform appeals if applicable.
• Duties performed may include one or more of the following core functions:
  • Directly interacting with or caring for patients;
  • Directly interacting with or caring for human-subjects research participants;
  • Regularly maintaining, modifying, releasing or similarly affecting patient records (including patient financial records);
  • Regularly maintaining, modifying, releasing or similarly affecting human-subjects research records.
• Performs other related duties as required.

Benefits

• 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.