Account Auditor

• 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! 
  
  JOB SUMMARY
• 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  
   

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%25 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!

EXPERIENCE AND EDUCATION

Required

• Education
  High School Diploma 
   

• Experience
  5 years' experience performing follow-up/collections, payment posting, appeals and managed care contract understanding/interpretation 
  May consider education in lieu of experience. 
   

Preferred

• Experience
  2 years related work experience performing appeals and managed care contract understanding/interpretation 
   

JOB DUTIES

• 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: (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 related duties as required.

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
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.